Brand Name | INTELLANAV MIFI OPEN-IRRIGATED |
Type of Device | CATHETER, PERCUTANEOUS, CARDIAC ABLATION, FOR TREATMENT OF ATRIAL FLUTTER |
Manufacturer (Section D) |
BOSTON SCIENTIFIC CORPORATION |
300 boston scientific way |
marlborough MA 01752 |
|
Manufacturer (Section G) |
BOSTON SCIENTIFIC CORPORATION |
302 parkway, global park |
|
la aurora - heredia |
CS
|
|
Manufacturer Contact |
timothy
degroot
|
4100 hamline avenue north |
dc a330 |
saint paul, MN 55112
|
6515826168
|
|
MDR Report Key | 15006357 |
MDR Text Key | 304692002 |
Report Number | 2134265-2022-07878 |
Device Sequence Number | 1 |
Product Code |
OAD
|
UDI-Device Identifier | 08714729938361 |
UDI-Public | 08714729938361 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | P150005/S017 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Health Professional,Company Representative |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
07/13/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 08/21/2023 |
Device Model Number | 87047 |
Device Catalogue Number | 87047 |
Device Lot Number | 0027882998 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 04/25/2022 |
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
06/16/2022 |
Initial Date FDA Received | 07/13/2022 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 08/21/2021 |
Is the Device Single Use? |
Yes
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |