| Brand Name | MOSAIC AORTIC BIOPROSTHETIC HEART VALVE |
| Common Device Name | HEART-VALVE, NON-ALLOGRAFT TISSUE |
| Manufacturer (Section D) |
| MEDTRONIC HEART VALVES DIVISION |
| 1851 e deere ave |
| santa ana CA 92705 |
|
| Manufacturer (Section G) |
| MEDTRONIC HEART VALVES DIVISION |
| 1851 e deere ave |
|
| santa ana CA 92705 |
|
| Manufacturer Contact |
|
alison
sweeney
|
| parkmore business park west |
| galway
|
|
EI
|
|
091708096
|
|
| MDR Report Key | 25633237 |
| Report Number | 2025587-2026-00692 |
| Device Sequence Number | 15307367 |
| Product Code |
DYE
|
| UDI-Device Identifier | 00643169001664 |
| UDI-Public | (01)00643169001664(17)180317 |
| Combination Product (Y/N) | N |
| Initial Reporter State | TX |
| Initial Reporter Country | US |
| PMA/510(K) Number | P990064 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2014 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial,Followup,Followup,Followup |
| Report Date (Section B) |
07/16/2026 |
| 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? |
Yes
|
| Operator of Device |
Health Professional
|
| Device Expiration Date | 03/17/2018 |
| Device Model Number | 305U223 |
| Device Catalogue Number | 305U223 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 06/24/2026 |
| Supplement Date Received by Manufacturer | 06/29/2026 Not provided 07/02/2026
|
| Initial Report FDA Received Date | 06/26/2026 |
| Supplement Report FDA Received Date | 07/08/2026 07/08/2026 07/16/2026
|
| Date Device Manufactured | 04/04/2013 |
| 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 |
| Outcome Attributed to Adverse Event |
Required Intervention;
Hospitalization;
Life Threatening;
|
| Patient Age | 78 YR |
| Patient Sex | Male |
| Patient Weight | 61 KG |