| Brand Name | 3M¿ RED DOT¿ |
| Common Device Name | ELECTRODE, ELECTROCARDIOGRAPH |
| Manufacturer (Section D) |
| 3M COMPANY |
| 3m center, 2510 conway ave. |
| bldg. 275-5w-06 |
| saint paul MN 55144 |
|
| MDR Report Key | 23756886 |
| Report Number | 23756886 |
| Device Sequence Number | 9993028 |
| Product Code |
DRX
|
| UDI-Device Identifier | 10707387789302 |
| UDI-Public | (01)10707387789302(17)271002(10)202710CC |
| Combination Product (Y/N) | N |
| Initial Reporter State | VA |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
User Facility
|
| Initial Reporter Occupation |
Nurse
|
| Type of Report
| Initial |
| Report Date (Section B) |
11/11/2025 |
| Report Date (Section F) |
11/11/2025 |
| 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 Model Number | 2560 |
| Device Catalogue Number | 2560 |
| Device Lot Number | 202710CC |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Was the Report Sent to FDA? |
Yes
|
| Event Location |
Hospital
|
| Date Report to Manufacturer | 12/09/2025 |
| Initial Date Received by Manufacturer | Not provided |
| Initial Report FDA Received Date | 12/09/2025 |
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Unknown
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Other;
|
| Patient Age | 75 YR |
| Patient Sex | Female |
| Patient Weight | 70 KG |
| Date Report Sent to FDA | 11/11/2025 |
|
|