Brand Name | ACHIEVE MAPPING CATHETER - 20 MM |
Type of Device | CATHETER, ELECTRODE RECORDING, OR PROBE, ELECTRODE RECORDING |
Manufacturer (Section D) |
MEDTRONIC MEXICO |
av. paseo del cucapah #10510 |
tijuana,bc 22570 |
MX 22570 |
|
Manufacturer (Section G) |
MEDTRONIC MEXICO |
av. paseo del cucapah #10510 |
|
tijuana,bc 22570 |
MX
22570
|
|
Manufacturer Contact |
paula
bixby
|
8200 coral sea st ne |
mounds view, MN 55112
|
7635055378
|
|
MDR Report Key | 9539985 |
MDR Text Key | 188282619 |
Report Number | 9612164-2020-00041 |
Device Sequence Number | 1 |
Product Code |
DRF
|
UDI-Device Identifier | 00643169467385 |
UDI-Public | 00643169467385 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K102588 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,health |
Reporter Occupation |
Physician
|
Type of Report
| Initial,Followup |
Report Date |
02/28/2020 |
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 | 09/19/2021 |
Device Model Number | 990063-020 |
Device Catalogue Number | 990063-020 |
Device Lot Number | 218454662 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 01/06/2020 |
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
12/09/2019
|
Initial Date FDA Received | 01/02/2020 |
Supplement Dates Manufacturer Received | 02/03/2020
|
Supplement Dates FDA Received | 02/28/2020
|
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 09/19/2019 |
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 |
|
|