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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT ENDURITY SR; IMPLANTABLE PACEMAKER PULSE GENERATOR

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ABBOTT ENDURITY SR; IMPLANTABLE PACEMAKER PULSE GENERATOR Back to Search Results
Model Number PM1160
Medical Device Problem Code Premature Discharge of Battery (1057)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/05/2023
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported, the device longevity decreased rapidly and triggered elective replacement indicator (eri) sooner then expected.The device was explanted and replaced to resolve the event.The patient was stable.
 
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Brand Name
ENDURITY SR
Common Device Name
IMPLANTABLE PACEMAKER PULSE GENERATOR
Manufacturer (Section D)
ABBOTT
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
ABBOTT
15900 valley view court
sylmar CA 91342
Manufacturer Contact
richard williamson
15900 valley view court
sylmar, CA 91342
MDR Report Key17125608
Report Number2017865-2023-23158
Device Sequence Number7377822
Product Code NVZ
UDI-Device Identifier05414734507042
UDI-Public05414734507042
Combination Product (Y/N)N
Initial Reporter CountryUK
PMA/510(K) Number
P880086
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2015
Device Explanted Year2023
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 10/16/2023
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? Yes
Operator of Device Health Professional
Device Expiration Date10/31/2016
Device Model NumberPM1160
Device Catalogue NumberPM1160
Device Lot NumberP000006723
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/06/2023
Supplement Date Received by Manufacturer10/16/2023
Initial Report FDA Received Date06/14/2023
Supplement Report FDA Received Date10/16/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured04/18/2015
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient SexUnknown
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