| Brand Name | INQWIRE® AMPLATZ |
| Common Device Name | WIRE, GUIDE, CATHETER |
| Manufacturer (Section D) |
| MERIT MEDICAL IRELAND, LTD. |
| parkmore business park west |
| galway, ireland H91 W 274 |
| EI H91 W274 |
|
| Manufacturer (Section G) |
| MERIT MEDICAL IRELAND, LTD. |
| parkmore business park west |
|
| galway, ireland H91 W 274 |
|
EI
H91 W274
|
|
| Manufacturer Contact |
|
lisa
perz msn, rn, pmp
|
| 1600 merit parkway |
| south jordan, UT 84095
|
|
8012084225
|
|
| MDR Report Key | 25882902 |
| Report Number | 9616662-2026-00065 |
| Device Sequence Number | 8057928 |
| Product Code |
DQX
|
| UDI-Device Identifier | 00884450355954 |
| UDI-Public | 00884450355954 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | HK |
| PMA/510(K) Number | K170700 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,User Facility,Company Representative |
| Initial Reporter Occupation |
Other
|
| 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
|
| Device Catalogue Number | IQA521 |
| Device Lot Number | K3315310 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Date Returned to Manufacturer | 07/16/2026 |
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 07/20/2026 |
| Initial Report FDA Received Date | 07/20/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 11/06/2025 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|