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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT ENTRANT BIPOLAR DF4 HF; NO MATCH

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ABBOTT ENTRANT BIPOLAR DF4 HF; NO MATCH Back to Search Results
Model Number CDHFA300D
Medical Device Problem Code Failure to Capture (1081)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/29/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that a loss of capture was observed on the device.It is unknown if the patient is pacemaker dependent.Technical support was contacted and the device was reprogrammed to resolve the event.The patient was stable and will continue to be monitored.
 
Additional Manufacturer Narrative
A device history record (dhr) review was performed and all required manufacturing processes and inspections steps were confirmed to be completed per the requirements.The device met specifications prior to leaving abbott manufacturing facilities.
 
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Brand Name
ENTRANT BIPOLAR DF4 HF
Common Device Name
NO MATCH
Manufacturer (Section D)
ABBOTT
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
ABBOTT
15900 valley view court
sylmar CA 91342
Manufacturer Contact
navpreet singh
15900 valley view court
sylmar, CA 91342
MDR Report Key24297606
Report Number2017865-2026-02653
Device Sequence Number18474751
Product Code NIK
UDI-Device Identifier05415067050120
UDI-Public(01)05415067050120(10)S000104309(17)270430
Combination Product (Y/N)N
Initial Reporter CountryGM
PMA/510(K) Number
P030054
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 04/06/2026
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 NumberCDHFA300D
Device Catalogue NumberCDHFA300D
Device Lot NumberS000104309
Was Device Available for Evaluation? No
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 01/29/2026
Supplement Date Received by Manufacturer04/06/2026
Initial Report FDA Received Date02/09/2026
Supplement Report FDA Received Date04/06/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured05/21/2025
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 Number1
Patient SexUnknown
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