| Brand Name | ALINITY I PROCESSING MODULE |
| Common Device Name | ANALYZER, CHEMISTRY (PHOTOMETRIC, DISCRETE), FOR CLINICAL USE |
| Manufacturer (Section D) |
| ABBOTT LABORATORIES |
| 1915 hurd drive |
| irving TX 75038 |
|
| Manufacturer (Section G) |
| ABBOTT LABORATORIES |
| 1915 hurd drive |
|
| irving TX 75038 |
|
| Manufacturer Contact |
|
nicole
jenne
|
| max-planck-ring 2 |
| post market surveillance |
| wiesbaden 65205
|
|
GM
65205
|
|
6122582960
|
|
| MDR Report Key | 25285642 |
| Report Number | 3016438761-2026-00287 |
| Device Sequence Number | 18583417 |
| Product Code |
JJE
|
| UDI-Device Identifier | 00380740137366 |
| UDI-Public | (01)00380740137366 |
| Combination Product (Y/N) | N |
| Initial Reporter State | MA |
| Initial Reporter Country | US |
| PMA/510(K) Number | K170317 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
06/15/2026 |
| 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 Catalogue Number | 03R65-01 |
| Was Device Available for Evaluation? |
Yes
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 05/12/2026 |
| Supplement Date Received by Manufacturer | 06/12/2026
|
| Initial Report FDA Received Date | 05/26/2026 |
| Supplement Report FDA Received Date | 06/15/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 03/20/2023 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Unknown
|
| Patient Sequence Number | 1 |
Concomitant Medical Products and Therapy/Usage Dates | ALIN I HS TNI 200T US, 04Z21-25, 85393UD00. |
| Patient Age | 45 YR |
| Patient Sex | Male |