PRUITT AORTIC OCCLUSION CATHETER 2100-12

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-09-27 for PRUITT AORTIC OCCLUSION CATHETER 2100-12 manufactured by Lemaitre Vascular, Inc..

MAUDE Entry Details

Report Number1220948-2019-00133
MDR Report Key9130893
Date Received2019-09-27
Date of Report2019-09-27
Date of Event2019-08-29
Date Mfgr Received2019-08-29
Device Manufacturer Date2019-02-21
Date Added to Maude2019-09-27
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. PRAGYA THIKEY
Manufacturer Street63 SECOND AVE
Manufacturer CityBURLINGTON MA 01803
Manufacturer CountryUS
Manufacturer Postal01803
Manufacturer Phone7812212266
Manufacturer G1LEMAITRE VASCULAR, INC.
Manufacturer Street63 SECOND AVE
Manufacturer CityBURLINGTON MA 01803
Manufacturer CountryUS
Manufacturer Postal Code01803
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NamePRUITT AORTIC OCCLUSION CATHETER
Generic NameAORTIC OCCLUSION CATHETER
Product CodeDQT
Date Received2019-09-27
Returned To Mfg2019-09-04
Catalog Number2100-12
Lot NumberPAO1213
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerLEMAITRE VASCULAR, INC.
Manufacturer Address63 SECOND AVE BURLINGTON MA 01803 US 01803


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2019-09-27

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