Brand Name | QUATTRO SUTURE PASSER NEEDLE |
Type of Device | NEEDLE |
Manufacturer (Section D) |
CAYENNE MEDICAL |
16597 n 92nd street |
101 |
scottsdale AZ 85260 |
|
Manufacturer (Section G) |
CAYENNE MEDICAL |
16597 n 92nd street |
101 |
scottsdale AZ 85260 |
|
Manufacturer Contact |
shima
hashemian
|
16597 n 92nd street |
101 |
scottsdale, AZ 85260
|
4805023661
|
|
MDR Report Key | 9803001 |
MDR Text Key | 182519794 |
Report Number | 3006108336-2020-00004 |
Device Sequence Number | 1 |
Product Code |
GAB
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | NA |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative |
Reporter Occupation |
Non-Healthcare Professional
|
Type of Report
| Initial,Followup |
Report Date |
04/23/2020 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 03/06/2020 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
|
Device Model Number | N/A |
Device Catalogue Number | CM-9011 |
Device Lot Number | 70113-1 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 03/02/2020 |
Is the Reporter a Health Professional? |
|
Was the Report Sent to FDA? |
No
|
Event Location |
No Information
|
Date Manufacturer Received | 02/06/2020 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 01/25/2019 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Removal/Correction Number | N/A |