Brand Name | ENDOPATH XCEL BLADELESS TROCAR |
Type of Device | LAPAROSCOPE, GENERAL AND PLASTIC SURGERY |
Manufacturer (Section D) |
ETHICON ENDO-SURGERY, LLC. |
475 calle c |
guaynabo 00969 |
* 00969 |
|
Manufacturer (Section G) |
ETHICON ENDO-SURGERY, LLC. |
475 calle c |
|
guaynabo 00969 |
*
00969
|
|
Manufacturer Contact |
kara
ditty-bovard
|
475 calle c |
guaynabo 00969
|
*
00969
|
6107428552
|
|
MDR Report Key | 9886421 |
MDR Text Key | 200282347 |
Report Number | 3005075853-2020-01812 |
Device Sequence Number | 1 |
Product Code |
GCJ
|
UDI-Device Identifier | 10705036001126 |
UDI-Public | 10705036001126 |
Combination Product (y/n) | N |
PMA/PMN Number | K032676 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,distri |
Reporter Occupation |
Other
|
Type of Report
| Initial |
Report Date |
03/20/2020 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 03/26/2020 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 02/29/2024 |
Device Model Number | B11LT |
Device Catalogue Number | B11LT |
Device Lot Number | T4047N |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 03/20/2020 |
Date Manufacturer Received | 03/20/2020 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 03/19/2019 |
Is the Device Single Use? |
Yes
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |