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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT QUARTET; No Match

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ABBOTT QUARTET; No Match Back to Search Results
Model Number 1458Q/86
Device Problems Therapy Delivered to Incorrect Body Area (1508); Capturing Problem (2891)
Patient Problem Discomfort (2330)
Event Date 03/07/2024
Event Type  Injury  
Event Description
During an in-clinic follow-up, increased capture threshold was on the left ventricular (lv) lead.The patient experienced phrenic nerve stimulation on all configuration of the lv lead.The lv lead was capped and replaced to resolve the event.The patient was stable.
 
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Brand Name
QUARTET
Type of Device
No Match
Manufacturer (Section D)
ABBOTT
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
ABBOTT
15900 valley view court
sylmar CA 91342
Manufacturer Contact
richard williamson
15900 valley view court
sylmar, CA 91342
MDR Report Key18899020
MDR Text Key337600897
Report Number2017865-2024-34875
Device Sequence Number1
Product Code NIK
UDI-Device Identifier05414734503198
UDI-Public05414734503198
Combination Product (y/n)Y
Reporter Country CodeGM
PMA/PMN Number
P030054
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial
Report Date 03/13/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/13/2024
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number1458Q/86
Device Lot NumberS000087189
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received03/07/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured06/21/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
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