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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Abbott Medical (CRM-Sylmar) Quartet Lead Small-S, 86 cm; Defibrillator, Automatic Implantable Cardioverter, With Cardiac Resynchronization (Crt-D)

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Abbott Medical (CRM-Sylmar) Quartet Lead Small-S, 86 cm; Defibrillator, Automatic Implantable Cardioverter, With Cardiac Resynchronization (Crt-D) Back to Search Results
Model Number 1456Q/86
Medical Device Problem Code High impedance (1291)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/03/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported through a remote transmission that noise over-sensing and high capture threshold were noted on the patient's pacemaker and the right atrial (ra) lead.Meanwhile, high pacing impedance measurements were noted on the patient's pacemaker, the left ventricular (lv) and the right ventricular (rv) leads from the same remote transmission.The patient was in stable condition.
 
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Brand Name
Quartet Lead Small-S, 86 cm
Common Device Name
Defibrillator, Automatic Implantable Cardioverter, With Cardiac Resynchronization (Crt-D)
Manufacturer (Section D)
Abbott Medical (CRM-Sylmar)
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
Abbott Medical (CRM-Sylmar)
15900 valley view court
sylmar CA 91342
Manufacturer Contact
navpreet singh
15900 valley view court
sylmar, CA 91342
MDR Report Key50314711
Report Number2017865-2026-17397
Device Sequence Number13229949
Product Code NIK
UDI-Device Identifier05414734510158
UDI-Public(01)05414734510158(10)A000123615(17)250331
Combination Product (Y/N)Y
Initial Reporter CountryAS
PMA/510(K) Number
P030054
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2023
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 08/19/2026
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 Expiration Date03/31/2025
Device Model Number1456Q/86
Device Lot NumberA000123615
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer Not provided
Initial Report FDA Received Date08/19/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured04/06/2022
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 Number1
Patient SexUnknown
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