| Brand Name | Amplatzer Septal Occluder |
| Common Device Name | Transcatheter Septal Occluder |
| Manufacturer (Section D) |
| Abbott Medical |
| 5050 nathan lane n |
| plymouth MN 55442 |
|
| Manufacturer (Section G) |
| St. Jude Medical #3014918977 |
| edificio #44 calle 0, ave. 2 |
|
| el coyol alajuela 1897- 4050 |
|
CS
1897-4050
|
|
| Manufacturer Contact |
|
karen
krouse
|
| 5050 nathan lane n |
| plymouth, MN 55442
|
|
+1(651)756-5400
|
|
| MDR Report Key | 50741473 |
| Report Number | 2135147-2026-06190 |
| Device Sequence Number | 10166730 |
| Product Code |
MLV
|
| UDI-Device Identifier | 00811806010113 |
| UDI-Public | (01)00811806010113(17)300228(10)10776033 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| PMA/510(K) Number | P000039 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2026 |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/11/2026 |
| 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 | 9-ASD-014 |
| Device Catalogue Number | 9-ASD-014 |
| Device Lot Number | 10776033 |
| 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 | 08/19/2026 |
| Initial Report FDA Received Date | 09/11/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 03/18/2025 |
| 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 |