| Brand Name | ZEPHYR ENDOBRONCHIAL VALVE |
| Common Device Name | ENDOBRONCHIAL VALVE |
| Manufacturer (Section D) |
| PULMONX CORPORATION |
| 700 chesapeake drive |
| redwood city CA 94063 |
|
| Manufacturer Contact |
|
|
| 700 chesapeake drive |
| redwood city, CA 94063
|
|
| MDR Report Key | 24274078 |
| Report Number | 3007797756-2026-00003 |
| Device Sequence Number | 13426539 |
| Product Code |
NJK
|
| UDI-Device Identifier | 00811907030621 |
| UDI-Public | (01)00811907030621(10)507346V50(17)270911 |
| Combination Product (Y/N) | N |
| Initial Reporter State | CA |
| Initial Reporter Country | US |
| PMA/510(K) Number | P180002 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,User Facility,Company Representative |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
02/04/2026 |
| 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 Model Number | ZEPHYR 4.0 J EDC |
| Device Catalogue Number | EDC-TS-4.0-J |
| Device Lot Number | 507346-V5.0 |
| Was Device Available for Evaluation? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 01/13/2026 |
| Initial Report FDA Received Date | 02/05/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 09/11/2024 |
| 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 |