| Brand Name | TRANS-RAY PLUS 7.5FR 35CC IAB WITH ACCESSORIES |
| Common Device Name | SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL |
| Manufacturer (Section D) |
| DATASCOPE CORP. |
| 15 law drive |
| fairfield NJ 07004 |
|
| Manufacturer (Section G) |
| DATASCOPE CORP. |
| 15 law drive |
|
| fairfield NJ 07004 |
|
| Manufacturer Contact |
|
ewelina
chorlowska
|
| 15 law drive |
| fairfield, NJ 07004
|
|
| MDR Report Key | 24868346 |
| Report Number | 2248146-2026-0000893 |
| Device Sequence Number | 18392135 |
| Product Code |
DSP
|
| UDI-Device Identifier | 10607567111711 |
| UDI-Public | (01)10607567111711(17)280326(10)3000464246(11)250326 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| PMA/510(K) Number | K122628 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,User Facility,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial,Followup,Followup |
| Report Date (Section B) |
05/18/2026 |
| 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 Model Number | 0684-00-0607 |
| Device Catalogue Number | 0684-00-0607 |
| Device Lot Number | 3000464246 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 03/25/2026 |
| Supplement Date Received by Manufacturer | 04/24/2026 05/15/2026
|
| Initial Report FDA Received Date | 04/14/2026 |
| Supplement Report FDA Received Date | 05/10/2026 05/18/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 03/26/2025 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Male |