Brand Name | G4 STEERABLE GUIDING CATHETER |
Type of Device | CATHETER, STEERABLE |
Manufacturer (Section D) |
ABBOTT MEDICAL |
5050 nathan lane n |
plymouth MN 55442 |
|
Manufacturer (Section G) |
ABBOTT VASCULAR, REG # 3005070406 |
3885 bohannon drive |
|
menlo park CA 94025 |
|
Manufacturer Contact |
karen
krouse
|
5050 nathan lane n |
plymouth, MN 55442
|
6517565400
|
|
MDR Report Key | 15674383 |
MDR Text Key | 302428616 |
Report Number | 2135147-2022-01806 |
Device Sequence Number | 1 |
Product Code |
DRA
|
UDI-Device Identifier | 08717648231025 |
UDI-Public | 08717648231025 |
Combination Product (y/n) | N |
Reporter Country Code | CA |
PMA/PMN Number | K190167 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Health Professional,Company Representative |
Reporter Occupation |
Physician
|
Type of Report
| Initial,Followup |
Report Date |
12/15/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 10/26/2022 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Health Professional
|
Device Expiration Date | 03/06/2023 |
Device Model Number | N/A |
Device Catalogue Number | SGC0701 |
Device Lot Number | 20304R356 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Date Manufacturer Received | 11/30/2022 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 03/07/2022 |
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 | 1 IMPLANTED MITRACLIP. |
Patient Outcome(s) |
Required Intervention;
|
Patient Age | 72 YR |
Patient Sex | Female |
Patient Ethnicity | Non Hispanic |
Patient Race | White |
|
|