| Brand Name | PULSETTO |
| Common Device Name | STIMULATOR, MUSCLE, POWERED |
| Manufacturer (Section D) |
| PULSETTO |
| 470 old worthington rd, ste 200 |
| westerville OH 43082 |
|
| MDR Report Key | 23512044 |
| Report Number | MW5178703 |
| Device Sequence Number | 8971392 |
| Product Code |
IPF
|
| Combination Product (Y/N) | N |
| Initial Reporter Country | US |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Voluntary
|
| Initial Reporter Occupation |
Patient
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
11/05/2025 |
| 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
|
| Was Device Available for Evaluation? |
No
|
| Type of Report(Section G) | Follow-Up |
| Initial Date Received by Manufacturer | Not provided |
| Supplement Date Received by Manufacturer | Not provided
|
| Initial Report FDA Received Date | 11/10/2025 |
| Supplement Report FDA Received Date | 11/12/2025
|
| Patient Sequence Number | 1 |
Concomitant Medical Products and Therapy/Usage Dates | CPAP(CONTINUOUS POSITIVE AIRWAY PRESSURE); LISINOPRIL; METOPROLOL SUCCINATE |
| Outcome Attributed to Adverse Event |
Other;
|
| Patient Age | 52 YR |
| Patient Sex | Male |
| Patient Weight | 117 KG |
| Patient Race | White |
|
|