| Brand Name | BIOMONITOR III |
| Common Device Name | Implantable Cardiac Monitor |
| Manufacturer (Section D) |
| Biotronik SE & Co. KG |
| woermannkehre 1 |
| berlin 12359 |
| GM 12359 |
|
| Manufacturer Contact |
|
|
| 6024 jean road |
| lake oswego, OR 97035
|
|
+1(877)245-9800
|
|
| MDR Report Key | 50833648 |
| Report Number | 1028232-2026-04385 |
| Device Sequence Number | 16018009 |
| Product Code |
MXD
|
| UDI-Device Identifier | 04035479158453 |
| UDI-Public | (01)04035479158453(17)240731 |
| Combination Product (Y/N) | N |
| Initial Reporter State | AZ |
| Initial Reporter Country | US |
| PMA/510(K) Number | K190548 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2023 |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/19/2026 |
| 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? |
No
|
| Operator of Device |
Health Professional
|
| Device Expiration Date | 07/31/2024 |
| Device Model Number | 436066 |
| Device Catalogue Number | 436066 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 09/23/2026 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/26/2026 |
| Initial Report FDA Received Date | 09/19/2026 |
| Date Device Manufactured | 01/27/2023 |
| 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 Number | 1 |
| Outcome Attributed to Adverse Event |
Hospitalization;
Required Intervention;
|
| Patient Sex | Male |