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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Abbott Medical (CRM-Sylmar) Entrant DR; Defibrillator, Automatic Implantable Cardioverter, With Cardiac Resynchronization (Crt-D)

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Abbott Medical (CRM-Sylmar) Entrant DR; Defibrillator, Automatic Implantable Cardioverter, With Cardiac Resynchronization (Crt-D) Back to Search Results
Model Number CDDRA300Q
Medical Device Problem Code Incorrect Measurement (1383)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/20/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during follow-up in-clinic, the patient's implantable cardioverter defibrillator (icd) exhibited diagnostic discrepancy.No changes or interventions were reported.There were no patient consequences.
 
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Brand Name
Entrant DR
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 Key50694633
Report Number2017865-2026-19035
Device Sequence Number14946133
Product Code NIK
UDI-Device Identifier05415067032843
UDI-Public(01)05415067032843(10)P000171610(17)250430
Combination Product (Y/N)N
Initial Reporter StateIA
Initial Reporter CountryUS
PMA/510(K) Number
P030054
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,User Facility,Company Representative
Initial Reporter Occupation Nurse
Type of Report Initial
Report Date (Section B) 09/09/2026
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 Date04/30/2025
Device Model NumberCDDRA300Q
Device Catalogue NumberCDDRA300Q
Device Lot NumberP000171610
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 08/20/2026
Initial Report FDA Received Date09/09/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured06/01/2023
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
Optisure; Tendril
Patient Age50 YR
Patient SexFemale
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