| Brand Name | ARROW ULTRAFLEX IAB: 7.5FR 40CC |
| Common Device Name | SYSTEM, BALLOON, INTRA-AORTIC |
| Manufacturer (Section D) |
| ARROW INTERNATIONAL LLC |
| morrisville NC |
|
| Manufacturer (Section G) |
| ARROW INTERNATIONAL INC. |
| 16 elizabeth drive |
|
| chelmsford MA 01824 |
|
| Manufacturer Contact |
|
sachin
sony
|
| 3015 carrington mill blvd |
| morrisville, NC 27560
|
|
| MDR Report Key | 24895676 |
| Report Number | 3010532612-2026-00338 |
| Device Sequence Number | 9036554 |
| Product Code |
DSP
|
| UDI-Device Identifier | 10801902145748 |
| UDI-Public | (01)10801902145748(11)251002(17)270930(10)18F25J0124(21) |
| Combination Product (Y/N) | N |
| Initial Reporter Country | CH |
| PMA/510(K) Number | K000729 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,User Facility |
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
03/19/2026 |
| 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
|
| Device Catalogue Number | IAB-06840-U |
| Device Lot Number | 18F25J0124 |
| Was Device Available for Evaluation? |
Yes
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 03/19/2026 |
| Supplement Date Received by Manufacturer | 05/08/2026
|
| Initial Report FDA Received Date | 04/16/2026 |
| Supplement Report FDA Received Date | 05/14/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Device Not Returned to Manufacturer
|
| Date Device Manufactured | 10/02/2025 |
| 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 |
| Patient Sex | Unknown |