Brand Name | PROMOTE ACCEL CRT-D |
Type of Device | IMPLANTABLE CARDIOVERTER DEFIBRILLATOR |
Manufacturer (Section D) |
ST. JUDE MEDICAL INC., CRMD |
15900 valley view ct |
slymar CA 91342 |
|
Manufacturer (Section G) |
ST. JUDE MEDICAL INC., CRMD |
15900 valley view ct |
|
slymar CA 91342 |
|
Manufacturer Contact |
cary
lawler
|
15900 valleyview ct |
slymar, CA 91342
|
8184932621
|
|
MDR Report Key | 3869551 |
MDR Text Key | 21803494 |
Report Number | 2938836-2014-02027 |
Device Sequence Number | 1 |
Product Code |
NIK
|
Combination Product (y/n) | N |
PMA/PMN Number | K030054 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Health Professional,User Facility,Company Representative |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
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 | 03/31/2011 |
Device Model Number | CD3215-36 |
Device Catalogue Number | SMTFY999 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Distributor Facility Aware Date | 09/06/2011 |
Device Age | 24 MO |
Event Location |
Hospital
|
Initial Date Manufacturer Received |
09/08/2011
|
Initial Date FDA Received | 01/13/2014 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 09/01/2009 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
|
|