| Brand Name | Rotarex |
| Common Device Name | Thrombectomy & Atherectomy |
| Manufacturer (Section D) |
| Straub Medical AG |
| straubstrasse 12 |
| ch-7323 |
| wangs SG 73 23 |
| SZ SG 7323 |
|
| Manufacturer (Section G) |
| Straub Medical AG |
| straubstrasse 12 |
| ch-7323 |
| wangs SG 73 23 |
|
SZ
SG 7323
|
|
| Manufacturer Contact |
|
michael
gaffney
|
| 800 w. rio salado pkwy |
| tempe, AZ 85281
|
|
+1(480)303-2689
|
|
| MDR Report Key | 50125519 |
| Report Number | 3008439199-2026-00273 |
| Device Sequence Number | 10513700 |
| Product Code |
MCW
|
| UDI-Device Identifier | 07640142811862 |
| UDI-Public | (01)07640142811862(17)281208(10)260326 |
| Combination Product (Y/N) | N |
| Initial Reporter State | OH |
| Initial Reporter Country | US |
| PMA/510(K) Number | K211738 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Other,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
09/30/2026 |
| 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 | 80237 |
| Device Lot Number | 260326 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 08/21/2026 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 07/13/2026 |
| Supplement Date Received by Manufacturer | 09/29/2026
|
| Initial Report FDA Received Date | 08/04/2026 |
| Supplement Report FDA Received Date | 10/01/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| 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 Sex | Unknown |