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U.S. Department of Health and Human Services

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

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Abbott Medical (CRM-Sylmar) Entrant HF; Defibrillator, Automatic Implantable Cardioverter, With Cardiac Resynchronization (Crt-D) Back to Search Results
Model Number CDHFA300Q
Medical Device Problem Code Capturing Problem (2891)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that varying capture thresholds were observed on the implantable cardioverter defibrillator (icd).
 
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Brand Name
Entrant HF
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 Key50718950
Report Number2017865-2026-19198
Device Sequence Number18656204
Product Code NIK
UDI-Device Identifier05415067032850
UDI-Public(01)05415067032850(10)A000156169(17)260430
Combination Product (Y/N)N
Initial Reporter CountryMU
PMA/510(K) Number
P030054
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 09/10/2026
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 Date04/30/2026
Device Model NumberCDHFA300Q
Device Catalogue NumberCDHFA300Q
Device Lot NumberA000156169
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 08/25/2026
Initial Report FDA Received Date09/10/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured04/09/2024
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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