| Brand Name | ASSURE WEARABLE CARDIOVERTER DEFIBRILLATOR |
| Common Device Name | WEARABLE AUTOMATED EXTERNAL DEFIBRILLATOR |
| Manufacturer (Section D) |
| KESTRA MEDICAL TECHNOLOGIES, INC. |
| 3933 lake washington blvd ne |
| ste 200 |
| kirkland WA 98033 |
|
| Manufacturer (Section G) |
| KESTRA MEDICAL TECHNOLOGIES, INC. |
| 3933 lake washington blvd ne |
| ste 200 |
| kirkland WA 98033 |
|
| Manufacturer Contact |
|
jay
wiese
|
| 3933 lake washington blvd ne |
| ste 200 |
| kirkland, WA 98033
|
|
+1(206)970-1994
|
|
| MDR Report Key | 50869448 |
| Report Number | 3015185344-2026-00486 |
| Device Sequence Number | 16131253 |
| Product Code |
MVK
|
| UDI-Device Identifier | 00840241600375 |
| UDI-Public | (01)00840241600375(11)260713 |
| Combination Product (Y/N) | N |
| Initial Reporter State | WA |
| Initial Reporter Country | US |
| PMA/510(K) Number | P200037 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Consumer,Company Representative |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Remedial Action |
Replace |
| Type of Report
| Initial |
| Report Date (Section B) |
09/23/2026 |
| 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 |
Lay User/Patient
|
| Device Model Number | 80014-003 |
| 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 | 09/22/2026 |
| Initial Report FDA Received Date | 09/23/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 07/13/2026 |
| 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 |
Reuse
|
| Patient Sequence Number | 1 |
| Patient Age | 58 YR |
| Patient Sex | Female |
| Patient Weight | 195 LB |