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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT DURATA STS OPTIM ACTIVE FIXATION; IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (NON-CRT)

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ABBOTT DURATA STS OPTIM ACTIVE FIXATION; IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (NON-CRT) Back to Search Results
Model Number 7122/65
Medical Device Problem Codes Low impedance (2285); Capturing Problem (2891)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that there as a decrease in defibrillation impedance and varying threshold that was observed on the right ventricular (rv) lead.Technical support was contacted and gave reprogramming recommendations.No intervention has been performed.
 
Additional Manufacturer Narrative
Further information was requested but not received.
 
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Brand Name
DURATA STS OPTIM ACTIVE FIXATION
Common Device Name
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (NON-CRT)
Manufacturer (Section D)
ABBOTT
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
ABBOTT MEDICAL
15900 valley view court
sylmar CA 91342
Manufacturer Contact
navpreet singh
15900 valley view court
sylmar, CA 91342
MDR Report Key24915687
Report Number2017865-2026-08087
Device Sequence Number9067635
Product Code LWS
UDI-Device Identifier05414734502153
UDI-Public(01)05414734502153(10)A000146751(17)260731
Combination Product (Y/N)Y
Initial Reporter CountryUK
PMA/510(K) Number
P950022
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 05/20/2026
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 Other
Device Expiration Date07/31/2026
Device Model Number7122/65
Device Lot NumberA000146751
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/02/2026
Supplement Date Received by Manufacturer05/08/2026
Initial Report FDA Received Date04/17/2026
Supplement Report FDA Received Date05/20/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured08/30/2023
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
Patient SexUnknown
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