| Brand Name | EVERFLEX SELF-EXPANDING PERIPHERAL STENT WITH ENTRUST DELIVERY SYSTEM LONG |
| Common Device Name | STENT, SUPERFICIAL FEMORAL ARTERY |
| Manufacturer (Section D) |
| COVIDIEN |
| 4600 nathan lane north |
| plymouth MN 55442 |
|
| Manufacturer (Section G) |
| COVIDIEN |
| 4600 nathan lane north |
|
| plymouth MN 55442 |
|
| Manufacturer Contact |
|
alison
sweeney
|
| parkmore business park west |
| galway
|
|
EI
|
|
091708096
|
|
| MDR Report Key | 25872661 |
| Report Number | 2183870-2026-00326 |
| Device Sequence Number | 15479702 |
| Product Code |
NIP
|
| UDI-Device Identifier | 00821684051252 |
| UDI-Public | (01)00821684051252(17)270710(10)B757316(20)02 |
| Combination Product (Y/N) | N |
| Initial Reporter State | NC |
| Initial Reporter Country | US |
| PMA/510(K) Number | P110023 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| Report Date (Section B) |
07/20/2026 |
| 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 | EVD35-07-150-080 |
| Device Lot Number | B757316 |
| 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 | 06/25/2026 |
| Initial Report FDA Received Date | 07/20/2026 |
| Date Device Manufactured | 07/10/2024 |
| 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 | 72 YR |
| Patient Sex | Male |