| Brand Name | FARAWAVE |
| Common Device Name | Percutaneous Cardiac Ablation Catheter For Treatment Of Atrial Fibrillation With Irreversible Electroporation |
| Manufacturer (Section D) |
| BOSTON SCIENTIFIC CORPORATION |
| 300 boston scientific way |
| marlborough MA 01752 |
|
| Manufacturer (Section G) |
| Boston Scientific Corporation |
| 302 parkway, global park |
|
| la aurora - heredia |
|
CS
|
|
| Manufacturer Contact |
|
mary
crawford
|
| 4100 hamline avenue north |
| dc a330 |
| saint paul, MN 55112
|
|
+1(651)440-0979
|
|
| MDR Report Key | 50914172 |
| Report Number | 2124215-2026-51359 |
| Device Sequence Number | 12094817 |
| Product Code |
QZI
|
| UDI-Device Identifier | 00191506043193 |
| Combination Product (Y/N) | N |
| Initial Reporter State | IN |
| Initial Reporter Country | US |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/28/2026 |
| 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 Lot Number | 0039220141 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 09/16/2026 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 09/01/2026 |
| Initial Report FDA Received Date | 09/28/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 04/29/2026 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |