| Brand Name | CELERO-12 |
| Common Device Name | INSTRUMENT, BIOPSY |
| Manufacturer (Section D) |
| Hologic, Inc. |
| 250 campus drive |
| marlborough MA 01752 |
|
| Manufacturer (Section G) |
| Hologic, Inc. |
| 250 campus drive |
|
| marlborough MA 01752 |
|
| Manufacturer Contact |
|
dara
smithers
|
| 600 technology dr |
| newark, DE 19702
|
|
| MDR Report Key | 50859980 |
| Report Number | 1222780-2026-00634 |
| Device Sequence Number | 10026566 |
| Product Code |
KNW
|
| UDI-Device Identifier | 15420045504929 |
| UDI-Public | (01)15420045504929(17)280121(10)E26A21R |
| Combination Product (Y/N) | N |
| Initial Reporter State | TN |
| Initial Reporter Country | US |
| PMA/510(K) Number | K034021 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
User Facility,Company Representative |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/22/2026 |
| 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 Model Number | CELERO-12 |
| Device Catalogue Number | CELERO-12 |
| Device Lot Number | E26A21R |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 09/04/2026 |
| Initial Report FDA Received Date | 09/22/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| 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 |
Other;
|
| Patient Sex | Unknown |
|
|