Mdr report key: 70856
Report Number: 1220857-1997-00278
Report Source Code: M
Manufacturer Link Flag: Y
Adverse Event Flag: Y
Product Problem Flag: N
Date Report: 1997-04-02
Date of Event: 1996-10-12
Reporter Occupation Code: 116
Health Professional: Y
Initial Report to FDA: U
Date facility Aware: 1997-02-04
Event Location: 004
Device date of Manufacture: 1993-01-11
Single Use Flag: Y
Remedial Action: RL
Previous Use Code: I
Removal Correction Number: NA
Event Type: IN
Type of Report: I
Source Type: 08
Reporter Country Code: US
Summary Report: N
NOE Summarized: 1
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