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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL (CRM-SYLMAR) ELLIPSE DR; Pulse generator, permanent, implantable

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ABBOTT MEDICAL (CRM-SYLMAR) ELLIPSE DR; Pulse generator, permanent, implantable Back to Search Results
Model Number CD2411-36Q
Medical Device Problem Code Failure to Capture (1081)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/06/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the patient presented remotely via merlin.Net.Review of the transmission revealed that the implantable cardioverter defibrillator exhibited loss of capture.Further information was requested however, was not provided.
 
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Brand Name
ELLIPSE DR
Common Device Name
Pulse generator, permanent, implantable
Manufacturer (Section D)
ABBOTT MEDICAL (CRM-SYLMAR)
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
ABBOTT MEDICAL (CRM-SYLMAR)
15900 valley view court
sylmar CA 91342
Manufacturer Contact
navpreet singh
15900 valley view court
sylmar, CA 91342
MDR Report Key24714934
Report Number2017865-2026-06315
Device Sequence Number5664660
Product Code NVZ
UDI-Device Identifier05414734507615
UDI-Public(01)05414734507615(10)S000076190(17)220430
Combination Product (Y/N)N
Initial Reporter StateOK
Initial Reporter CountryUS
PMA/510(K) Number
P910023
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2020
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 03/27/2026
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 Date04/30/2022
Device Model NumberCD2411-36Q
Device Catalogue NumberCD2411-36Q
Device Lot NumberS000076190
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 03/06/2026
Initial Report FDA Received Date03/30/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured04/13/2020
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
OPTISURE; TENDRIL
Patient Age66 YR
Patient SexUnknown
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