| Brand Name | UNKNOWN_NEUROVASCULAR_PRODUCT |
| Common Device Name | Catheter, Percutaneous |
| Manufacturer (Section D) |
| STRYKER NEUROVASCULAR CORK |
| ida industrial estate |
| model farm road |
| cork NA |
| EI NA |
|
| Manufacturer (Section G) |
| Stryker Neurovascular Cork |
| ida industrial estate |
| model farm road |
| cork NA |
|
EI
NA
|
|
| Manufacturer Contact |
|
tara
lopez
|
| 47900 bayside parkway |
| fremont, CA 94538
|
|
+1(510)413-2500
|
|
| MDR Report Key | 25280446 |
| Report Number | 3008881809-2026-00337 |
| Device Sequence Number | 10059647 |
| Product Code |
DQY
|
| UDI-Device Identifier | 07613327298260 |
| UDI-Public | (01)07613327298260(17)290104(10)26061122 |
| Combination Product (Y/N) | N |
| Initial Reporter State | OR |
| Initial Reporter Country | US |
| PMA/510(K) Number | K152876 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
08/06/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
Yes
|
| Is this a Product Problem Report? |
No
|
| Operator of Device |
Health Professional
|
| Device Catalogue Number | UNK_NEU |
| 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 | 05/06/2026 |
| Supplement Date Received by Manufacturer | 07/16/2026
|
| Initial Report FDA Received Date | 05/26/2026 |
| Supplement Report FDA Received Date | 08/06/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 01/06/2026 |
| 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 |
Concomitant Medical Products and Therapy/Usage Dates | SURPASS ELITE WITH GUARDIAN FD (STRYKER).; XT27 MICROCATHETER (STRYKER). |
| Outcome Attributed to Adverse Event |
Required Intervention;
Other;
|
| Patient Age | 79 YR |
| Patient Sex | Female |