| Brand Name | NEUROGUARD IEP SYSTEM |
| Common Device Name | STENT, CAROTID |
| Manufacturer (Section D) |
| CONTEGO MEDICAL, INC. |
| 3801 lake boone trail |
| suite 100 |
| raleigh NC 27607 |
|
| Manufacturer (Section G) |
| CONTEGO MEDICAL, INC. |
| 3801 lake boone trail |
| suite 100 |
| raleigh NC 27607 |
|
| Manufacturer Contact |
|
james
clossick
|
| 3801 lake boone trail, suite 100 |
| raleigh, NC 27607
|
|
3056071708
|
|
| MDR Report Key | 25787271 |
| Report Number | 3011471056-2026-00042 |
| Device Sequence Number | 13442150 |
| Product Code |
NIM
|
| UDI-Device Identifier | 00851616007613 |
| UDI-Public | 00851616007613 |
| Combination Product (Y/N) | N |
| Initial Reporter State | WI |
| Initial Reporter Country | US |
| PMA/510(K) Number | P240009 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2025 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| 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 Model Number | NG-0740-140-2 |
| Device Catalogue Number | NG-0740-140-2 |
| Device Lot Number | Z2460774B |
| 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 | 05/22/2025 |
| Initial Report FDA Received Date | 07/10/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 04/17/2025 |
| 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 |
| Patient Age | 83 YR |
| Patient Sex | Female |
| Patient Weight | 75 KG |
|
|