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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL (CRM-SYLMAR) QUADRA ASSURA CRT-D QUAD RF HV; NO MATCH

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ABBOTT MEDICAL (CRM-SYLMAR) QUADRA ASSURA CRT-D QUAD RF HV; NO MATCH Back to Search Results
Model Number CD3365-40Q
Medical Device Problem Code Over-Sensing (1438)
Health Effect - Clinical Codes Insufficient Information (4580); No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Further information was requested but was not available at this time.
 
Event or Problem Description
It was reported that post paced t wave oversensing was observed on the implantable cardioverter defibrillator (icd).
 
Additional Manufacturer Narrative
Correction: section e: physician corrected to (b)(6).
 
Event or Problem Description
New information received notes the issue was discovered in clinic and the patient was asymptomatic.No programming changes were made.The patient's condition was good.The patient was being monitored,.
 
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Brand Name
QUADRA ASSURA CRT-D QUAD RF HV
Common Device Name
NO MATCH
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 Key24868007
Report Number2017865-2026-07683
Device Sequence Number10002133
Product Code NIK
UDI-Device Identifier05414734508292
UDI-Public(01)05414734508292(10)A000061403(17)200731
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
P030054
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2018
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 05/21/2026
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 Date07/31/2020
Device Model NumberCD3365-40Q
Device Catalogue NumberCD3365-40Q
Device Lot NumberA000061403
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 03/25/2026
Supplement Date Received by Manufacturer05/17/2026
Initial Report FDA Received Date04/14/2026
Supplement Report FDA Received Date05/21/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/11/2018
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 TACHY MRI.; QUARTET.; TENDRIL MRI.
Patient SexFemale
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