| Brand Name | SYNCHRO2-14 STANDARD STRAIGHT 200CM |
| Common Device Name | Wire, Guide, Catheter |
| Manufacturer (Section D) |
| STRYKER NEUROVASCULAR-UTAH-SALT LAKE CITY |
| 4870 west 2100 south |
| salt lake city UT 84120 |
|
| Manufacturer (Section G) |
| Stryker Neurovascular-Utah-Salt Lake City |
| 4870 west 2100 south |
|
| salt lake city UT 84120 |
|
| Manufacturer Contact |
|
tara
lopez
|
| 47900 bayside parkway |
| fremont, CA 94538
|
|
+1(510)413-2500
|
|
| MDR Report Key | 25519896 |
| Report Number | 3012931345-2026-00102 |
| Device Sequence Number | 15937709 |
| Product Code |
DQX
|
| UDI-Device Identifier | 04546540688767 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | US |
| PMA/510(K) Number | K053268 |
| 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) |
09/02/2026 |
| 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 | M00326410 |
| Device Lot Number | 0001058665 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 07/15/2026 |
| Is the Reporter a Health Professional? |
No
|
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Initial |
| Initial Date Received by Manufacturer | 05/28/2026 |
| Supplement Date Received by Manufacturer | 09/01/2026
|
| Initial Report FDA Received Date | 06/16/2026 |
| Supplement Report FDA Received Date | 09/02/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| 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 |
Concomitant Medical Products and Therapy/Usage Dates | TREVO TRACK 21 MICROCATHETER (STRYKER). |
| Patient Age | 59 YR |
| Patient Sex | Female |
| Patient Weight | 154 LB |
|
|