| Brand Name | Tablo Hemodialysis System, Cartridge |
| Common Device Name | Dialyzer, High Permeability With Or Without Sealed Dialysate System |
| Manufacturer (Section D) |
| Outset Medical, Inc. |
| 3052 orchard drive |
| san jose CA 95134 |
|
| Manufacturer (Section G) |
| Outset Medical, Inc. |
| 3052 orchard drive |
|
| san jose CA 95134 |
|
| Manufacturer Contact |
|
dinamarie
stefani
|
| 3052 orchard drive |
| san jose, CA 95134
|
|
+1(669)231-8200
|
|
| MDR Report Key | 50226092 |
| Report Number | 3010355846-2026-00081 |
| Device Sequence Number | 10256544 |
| Product Code |
KDI
|
| UDI-Device Identifier | 10850001011256 |
| UDI-Public | (01)10850001011256(17)270831(10)M26057L02S01 |
| Combination Product (Y/N) | N |
| Initial Reporter State | HI |
| Initial Reporter Country | US |
| PMA/510(K) Number | K190793 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Consumer,Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
08/12/2026 |
| 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 |
Lay User/Patient
|
| Device Lot Number | M26057L02S01 |
| 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 | 07/13/2026 |
| Initial Report FDA Received Date | 08/12/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 02/26/2026 |
| 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 | Male |