Mdr report key: 70860
Report Number: 2126328-1997-00779
Report Source Code: M
Manufacturer Link Flag: Y
Adverse Event Flag: Y
Product Problem Flag: N
Reporter Occupation Code: 1
Health Professional: Y
Initial Report to FDA: U
Event Location: NA
Date Manufacturer Received: 1996-05-12
Device date of Manufacture: 1991-01-02
Single Use Flag: Y
Previous Use Code: I
Event Type: IN
Type of Report: I,F
Source Type: 05
Reporter Country Code: AS
Summary Report: N
NOE Summarized: 1
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