| Brand Name | PK Papyrus US 3.0/26 |
| Common Device Name | Covered Coronary Stent System |
| Manufacturer (Section D) |
| BIOTRONIK AG |
| ackerstrasse 6 |
| bulach, zurich 8180 |
| SZ 8180 |
|
| Manufacturer (Section G) |
| BIOTRONIK AG |
| ackerstrasse 6 |
|
| bulach, zurich 8180 |
|
SZ
8180
|
|
| Manufacturer Contact |
|
jana
burger
|
| ackerstrasse 6 |
| bulach, zurich 8180
|
|
SZ
8180
|
|
| MDR Report Key | 50469876 |
| Report Number | 8043892-2026-08122 |
| Device Sequence Number | 10172528 |
| Product Code |
NIV
|
| UDI-Device Identifier | 07640130447271 |
| Combination Product (Y/N) | N |
| Initial Reporter State | IA |
| Initial Reporter Country | US |
| PMA/510(K) Number | H17004 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
User Facility,Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
08/27/2026 |
| 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 Model Number | 434899 |
| Device Lot Number | 01253453 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/12/2026 |
| Initial Report FDA Received Date | 08/27/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 02/13/2025 |
| 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 |