| Brand Name | CONFIRM |
| Common Device Name | RECORDER, EVENT, IMPLANTABLE CARDIAC, (WITHOUT ARRHYTHMIA DETECTION) |
| Manufacturer (Section D) |
| ABBOTT |
| 15900 valley view court |
| sylmar CA 91342 |
|
| Manufacturer (Section G) |
| ST. JUDE MEDICAL, INC.(CRM-SYLMAR) |
| 15900 valley view court |
|
| sylmar CA 91342 |
|
| Manufacturer Contact |
|
navpreet
singh
|
| 15900 valley view court |
| sylmar, CA 91342
|
|
| MDR Report Key | 22869050 |
| Report Number | 2017865-2025-98338 |
| Device Sequence Number | 15675813 |
| Product Code |
MXC
|
| UDI-Device Identifier | 05415067027320 |
| UDI-Public | (01)05415067027320(10)P000166408(17)240921 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | IT |
| PMA/510(K) Number | K163407 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2023 |
| 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) |
09/12/2025 |
| 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 Expiration Date | 09/21/2024 |
| Device Model Number | DM3500 |
| Device Lot Number | P000166408 |
| 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 | 07/30/2025 |
| Supplement Date Received by Manufacturer | 08/24/2025
|
| Initial Report FDA Received Date | 08/21/2025 |
| Supplement Report FDA Received Date | 09/12/2025
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 03/30/2023 |
| 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 |
| Patient Sex | Unknown |
|
|