Brand Name | LASSOSTAR¿ CIRCULAR MAPPING CATHETER |
Type of Device | CATHETER, ELECTRODE RECORDING OR PROBE, ELECTRODE RECORDING |
Manufacturer (Section D) |
BIOSENSE WEBSTER INC |
31 technology drive, suite 200 |
irvine CA 92618 |
|
Manufacturer (Section G) |
BIOSENSE WEBSTER INC (JUAREZ) |
circuito interior norte |
1820parque industrial salvacar |
juarez 32599 |
MX
32599
|
|
Manufacturer Contact |
gabriel
alfageme
|
31 technology dr |
irvine, CA 92618
|
9497898687
|
|
MDR Report Key | 13691075 |
MDR Text Key | 286863722 |
Report Number | 2029046-2022-00478 |
Device Sequence Number | 1 |
Product Code |
DRF
|
Combination Product (y/n) | N |
Reporter Country Code | JA |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Study,Literature,Company Representative |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial |
Report Date |
03/07/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Health Professional
|
Device Catalogue Number | UNK_LASSO |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
02/18/2022
|
Initial Date FDA Received | 03/08/2022 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
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 |
Treatment | CARTO; INQUIRY OPTIMA, ABBOTT. |
Patient Outcome(s) |
Life Threatening;
|