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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOTRONIK SE & CO. KG ILIVIA 7 DR-T DF4 PROMRI; ICD

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BIOTRONIK SE & CO. KG ILIVIA 7 DR-T DF4 PROMRI; ICD Back to Search Results
Model Number 404623
Medical Device Problem Code Premature End-of-Life Indicator (1480)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/05/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Biotronik submits this report to comply with fda regulations 21 cfr parts 4 and 803.Biotronik has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by biotronik, or its employees that the device, biotronik, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Biotronik will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
This device was explanted due to eos with unexpected battery behavior.No adverse patient events were reported.Should additional information become available, this file will be updated.
 
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Brand Name
ILIVIA 7 DR-T DF4 PROMRI
Common Device Name
ICD
Manufacturer (Section D)
BIOTRONIK SE & CO. KG
woermannkehre 1
berlin 12359
DE  12359
Manufacturer Contact
6024 jean road
lake oswego, OR 97035
8772459800
MDR Report Key24845138
Report Number1028232-2026-01769
Device Sequence Number14900480
Product Code MRM
UDI-Device Identifier04035479142100
UDI-Public(01)04035479142100(17)181231
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P050023
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2017
Device Explanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Remedial Action Recall
Type of Report Initial
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 Date12/31/2018
Device Model Number404623
Device Catalogue Number404623
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/15/2026
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/01/2026
Initial Report FDA Received Date04/10/2026
Date Device Manufactured06/09/2017
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 Hospitalization; Required Intervention;
Patient Age64 YR
Patient SexMale
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