| Brand Name | PEEL-AWAY INTRODUCER 14 CM SHEATH INTRODUCER KIT, 8F |
| Common Device Name | Introducer, catheter |
| 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 Key | 24729170 |
| Report Number | 2017865-2026-06490 |
| Device Sequence Number | 10248476 |
| Product Code |
DYB
|
| UDI-Device Identifier | 05415067040893 |
| UDI-Public | (01)05415067040893(10)10168412(17)261231 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | CH |
| PMA/510(K) Number | K894431 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Other,Foreign,Health Professional,User Facility,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| Report Date (Section B) |
03/30/2026 |
| 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? |
No
|
| Operator of Device |
Health Professional
|
| Device Model Number | 405112 |
| Device Catalogue Number | 405112 |
| Device Lot Number | 10168412 |
| 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 | 03/10/2026 |
| Initial Report FDA Received Date | 03/30/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 01/22/2024 |
| 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 |
| Outcome Attributed to Adverse Event |
Required Intervention;
Other;
|
| Patient Sex | Unknown |
|
|