Brand Name | ADVISOR¿ FL, CIRCULAR MAPPING CATHETER, SENSOR ENABLED¿ |
Type of Device | CATHETER, ELECTRODE RECORDING, OR PROBE, ELECTRODE RECORDING |
Manufacturer (Section D) |
ST. JUDE MEDICAL |
parque industrial, zona franca coyol s.a. |
edificio #44b, calle 0, avenida 2, coyol |
alajuela, costa rica 1897- 4050 |
CS 1897-4050 |
|
Manufacturer (Section G) |
ST. JUDE MEDICAL, COSTA RICA LTDA (AFD) |
parque industrial, zona franca coyol s.a. |
edificio #44b, calle 0, avenida 2, coyol |
alajuela, costa rica 1897- 4050 |
CS
1897-4050
|
|
Manufacturer Contact |
janna
parks
|
5050 nathan lane north |
plymouth, MN 55442
|
6517565400
|
|
MDR Report Key | 18778608 |
MDR Text Key | 336229520 |
Report Number | 3008452825-2024-00105 |
Device Sequence Number | 1 |
Product Code |
DRF
|
UDI-Device Identifier | 05415067024800 |
UDI-Public | (01)05415067024800(10)8622315(17)240131 |
Combination Product (y/n) | N |
Reporter Country Code | CH |
PMA/PMN Number | K160335, K20 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup,Followup |
Report Date |
04/02/2024 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 02/26/2024 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 01/31/2024 |
Device Model Number | D-AVSE-D10-F15 |
Device Lot Number | 8622315 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
No
|
Was the Report Sent to FDA? |
No
|
Date Manufacturer Received | 04/02/2024 |
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 08/18/2022 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Patient Sequence Number | 1 |
|
|