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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Abbott Medical (CRM-Sylmar) Quadra Assura MP ICD; Defibrillator, Automatic Implantable Cardioverter, With Cardiac Resynchronization (Crt-D)

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Abbott Medical (CRM-Sylmar) Quadra Assura MP ICD; Defibrillator, Automatic Implantable Cardioverter, With Cardiac Resynchronization (Crt-D) Back to Search Results
Model Number CD3369-40C
Medical Device Problem Code Over-Sensing (1438)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the patient presented in clinic.A device interrogation showed that the patient's implantable cardioverter defibrillator (icd) exhibited post-paced t-wave oversensing.Programming changes were made.The patient had no adverse consequences due to the event.
 
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Brand Name
Quadra Assura MP ICD
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 Key50324427
Report Number2017865-2026-17432
Device Sequence Number13190489
Product Code NIK
UDI-Device Identifier05414734508346
UDI-Public(01)05414734508346(10)A000109883(17)230531
Combination Product (Y/N)N
Initial Reporter StateLA
Initial Reporter CountryUS
PMA/510(K) Number
P030054
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2021
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source 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 Date05/31/2023
Device Model NumberCD3369-40C
Device Catalogue NumberCD3369-40C
Device Lot NumberA000109883
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 Manufactured05/14/2021
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
Concomitant Medical Products
and Therapy/Usage Dates
Durata; Quartet; Tendril
Patient Age61 YR
Patient SexFemale
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