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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL, INC.(CRM-SYLMAR) CONFIRM; RECORDER, EVENT, IMPLANTABLE CARDIAC, (WITHOUT ARRHYTHMIA DETECTION)

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ST. JUDE MEDICAL, INC.(CRM-SYLMAR) CONFIRM; RECORDER, EVENT, IMPLANTABLE CARDIAC, (WITHOUT ARRHYTHMIA DETECTION) Back to Search Results
Model Number DM3500
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Discomfort (2330)
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
The product was returned.The interrogation results were normal and the visual screen was acceptable.
 
Event or Problem Description
It was reported that the patient presented with symptoms of skin discomfort caused by the implantable cardiac monitor (icm).The icm was explanted.There were no patient consequences.
 
Additional Manufacturer Narrative
Correction: section d6b - the correct " date of explant" should have been (b)(6) 2025.
 
Additional Manufacturer Narrative
Correction: section b1 ¿ type of report "product problem" checkbox should not be checked.
 
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Brand Name
CONFIRM
Common Device Name
RECORDER, EVENT, IMPLANTABLE CARDIAC, (WITHOUT ARRHYTHMIA DETECTION)
Manufacturer (Section D)
ST. JUDE MEDICAL, INC.(CRM-SYLMAR)
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 Key24288529
Report Number2017865-2026-02681
Device Sequence Number21413608
Product Code MXC
UDI-Device Identifier05415067027320
UDI-Public(01)05415067027320(10)P000187708(17)250530
Combination Product (Y/N)N
Initial Reporter StateAZ
Initial Reporter CountryUS
PMA/510(K) Number
K163407
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Device Explanted Year2025
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date (Section B) 02/11/2026
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
Operator of Device Health Professional
Device Expiration Date05/30/2025
Device Model NumberDM3500
Device Lot NumberP000187708
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/26/2026
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 01/26/2026
Supplement Date Received by Manufacturer02/10/2026
02/11/2026
Initial Report FDA Received Date02/08/2026
Supplement Report FDA Received Date02/10/2026
02/11/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/03/2023
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 Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient Age43 YR
Patient SexFemale
Patient Weight116 KG
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