| Brand Name | VIEWFLEX¿ XTRA ICE CATHETER |
| Common Device Name | CATHETER, ULTRASOUND, INTRAVASCULAR |
| Manufacturer (Section D) |
| ABBOTT MEDICAL |
| parque industrial, zona franca coyol s.a. |
| edificio #44b, calle 0, avenida 2, coyol |
| alajuela, costa rica 1897- 4050 |
| CS 1897-4050 |
|
| Manufacturer (Section G) |
| ABBOTT MEDICAL |
| parque industrial, zona franca coyol s.a. |
| edificio #44b, calle 0, avenida 2, coyol |
| alajuela, costa rica 1897- 4050 |
|
CS
1897-4050
|
|
| Manufacturer Contact |
|
wendy
mccarty
|
| 5050 nathan lane north |
| plymouth, MN 55442
|
|
6517565400
|
|
| MDR Report Key | 23605205 |
| Report Number | 3008452825-2025-00607 |
| Device Sequence Number | 15754120 |
| Product Code |
OBJ
|
| UDI-Device Identifier | 05415067002082 |
| UDI-Public | (01)05415067002082(10)11030034(17)260831 |
| Combination Product (Y/N) | N |
| Initial Reporter State | CO |
| Initial Reporter Country | US |
| PMA/510(K) Number | K223077 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| 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) |
01/13/2026 |
| 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
|
| Operator of Device |
Health Professional
|
| Device Expiration Date | 08/31/2026 |
| Device Model Number | D087031 |
| Device Catalogue Number | D087031 |
| Device Lot Number | 11030034 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| 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 | 11/12/2025 |
| Supplement Date Received by Manufacturer | 12/26/2025
|
| Initial Report FDA Received Date | 11/20/2025 |
| Supplement Report FDA Received Date | 01/13/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 09/04/2025 |
| 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 |
|
|