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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL, INC.(CRM-SYLMAR) GALLANT ¿ HF; NO MATCH

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ST. JUDE MEDICAL, INC.(CRM-SYLMAR) GALLANT ¿ HF; NO MATCH Back to Search Results
Model Number CDHFA500T
Medical Device Problem Code Over-Sensing (1438)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that a patient presented with post-paced t-wave over-sensing noted on the patient's implantable4 cardioverter defibrillator.No information regarding intervention or adverse patient consequences was reported.
 
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Brand Name
GALLANT ¿ HF
Common Device Name
NO MATCH
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 Key24623856
Report Number2017865-2026-05593
Device Sequence Number12933865
Product Code NIK
UDI-Device Identifier05415067049520
UDI-Public(01)05415067049520(10)S000093909(17)260131
Combination Product (Y/N)N
Initial Reporter CountryUS
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 Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 04/10/2026
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 Date01/31/2026
Device Model NumberCDHFA500T
Device Catalogue NumberCDHFA500T
Device Lot NumberS000093909
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/26/2026
Supplement Date Received by Manufacturer03/27/2026
Initial Report FDA Received Date03/17/2026
Supplement Report FDA Received Date04/11/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured03/07/2024
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 Number1
Concomitant Medical Products
and Therapy/Usage Dates
DURATA.; QUARTET.; ULTIPACE.
Patient Age81 YR
Patient SexMale
Patient Weight95 KG
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