Brand Name | SYNCARDIA FREEDOM DRIVER |
Type of Device | CIRCULATORY ASSIST DEVICE |
Manufacturer (Section D) |
SYNCARDIA SYSTEMS, INC. |
tucson AZ |
|
Manufacturer Contact |
carole
marcot, esq, vp
|
1992 e. silverlake rd. |
tucson, AZ 85713
|
5205451234
|
|
MDR Report Key | 4080906 |
MDR Text Key | 4824645 |
Report Number | 3003761017-2014-00128 |
Device Sequence Number | 1 |
Product Code |
LOZ
|
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | P030011 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Health Professional,User Facility |
Reporter Occupation |
Other Health Care Professional
|
Remedial Action |
Replace |
Type of Report
| Initial |
Report Date |
08/27/2014 |
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 Catalogue Number | 595000-001 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
08/07/2014
|
Initial Date FDA Received | 08/27/2014 |
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 09/01/2010 |
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Reuse
|
Patient Sequence Number | 1 |
Patient Age | 44 YR |
|
|