ALTERA HANDSET (NO COST)

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-18 for ALTERA HANDSET (NO COST) manufactured by Pari Respiratory Equipment, Inc..

Event Text Entries

[184522816] Pt uses the altera device to administer her cayston medication 75 mg three times a day for 2 weeks on and 2 weeks off. Ndc for cayston is 61958-0901-01. Pt stated the machine broke that she uses to initiate her cayston. No add'l info. Pt did not report any adverse events, unk if she missed any doses, has the device on hand for investigation or if she had a backup. New device shipped 03/03/2020. Product lot number and expiration date unk. Reported to (b)(6) by pt/caregiver.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5093842
MDR Report Key9853376
Date Received2020-03-18
Date of Report2020-03-01
Date of Event2020-01-01
Date Added to Maude2020-03-19
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Sequence Number: 1

Brand NameALTERA HANDSET (NO COST)
Generic NameNEBULIZER (DIRECT PATIENT INTERFACE)
Product CodeCAF
Date Received2020-03-18
Device Availability*
Device Sequence No1
Device Event Key0
ManufacturerPARI RESPIRATORY EQUIPMENT, INC.

Device Sequence Number: 101

Brand NameGILEAD
Product Code---
Date Received2020-03-18
Device Sequence No101
Device Event Key0


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-18

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