| Brand Name | INFINITY¿ 5 IMPLANTABLE PULSE GENERATOR |
| Common Device Name | STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR |
| Manufacturer (Section D) |
| ABBOTT MEDICAL |
| 6901 preston rd |
| plano TX 75024 |
|
| Manufacturer (Section G) |
| ABBOTT MEDICAL |
| 6901 preston rd |
|
| plano TX 75024 |
|
| Manufacturer Contact |
|
heidi
syndergaard
|
| 6901 preston road |
| plano, TX 75024
|
|
9723098000
|
|
| MDR Report Key | 21442833 |
| Report Number | 1627487-2025-00876 |
| Device Sequence Number | 7968430 |
| Product Code |
MHY
|
| UDI-Device Identifier | 05415067020246 |
| UDI-Public | (01)05415067020246(10)T00005118(17)241106 |
| Combination Product (Y/N) | N |
| Initial Reporter State | NY |
| Initial Reporter Country | US |
| PMA/510(K) Number | P140009 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2023 |
| Device Explanted Year | 2025 |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
03/02/2025 |
| 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 Date | 11/06/2024 |
| Device Model Number | 6660 |
| Device Catalogue Number | 6660 |
| Device Lot Number | T00005118 |
| 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 | 02/03/2025 |
| Supplement Date Received by Manufacturer | 02/26/2025
|
| Initial Report FDA Received Date | 02/23/2025 |
| Supplement Report FDA Received Date | 03/02/2025
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 11/07/2022 |
| 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 Number | 1 |
Concomitant Medical Products and Therapy/Usage Dates | DBS BURR HOLE COVER; DBS EXTENSION; DBS LEAD |
| Outcome Attributed to Adverse Event |
Other;
|
| Patient Sex | Male |
| Patient Weight | 88 KG |