| Brand Name | Shockwave IVL System with the Shockwave M5+ Peripheral IVL Catheter |
| Common Device Name | Shockwave IVL System with the Shockwave M5+ Peripheral IVL Catheter |
| Manufacturer (Section D) |
| Shockwave Medical, Inc. |
| 5403 betsy ross drive |
| santa clara CA 95054 |
|
| Manufacturer (Section G) |
| Shockwave Medical, Inc. |
| 5403 betsy ross drive |
|
| santa clara CA 95054 |
|
| Manufacturer Contact |
|
alexis
weil
|
| 5403 betsy ross drive |
| santa clara, CA 95054
|
|
| MDR Report Key | 50576271 |
| Report Number | 3015053858-2026-00105 |
| Device Sequence Number | 10351526 |
| Product Code |
PPN
|
| UDI-Device Identifier | 00195451000218 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | GM |
| PMA/510(K) Number | K203365 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| 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) |
09/02/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
Yes
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Health Professional
|
| Device Expiration Date | 08/31/2026 |
| Device Model Number | M5PIVL4060 |
| Device Catalogue Number | M5PIVL4060 |
| Device Lot Number | 08B250228A |
| 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 | 08/25/2026 |
| Initial Report FDA Received Date | 09/02/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 02/28/2025 |
| 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 |
| Outcome Attributed to Adverse Event |
Hospitalization;
Required Intervention;
Other;
|
| Patient Sex | Unknown |