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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Abbott Medical (CRM-Sylmar) AVEIR AR 2 Leadless Pacemaker

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Abbott Medical (CRM-Sylmar) AVEIR AR 2 Leadless Pacemaker Back to Search Results
Model Number LSP203A
Medical Device Problem Code Device Dislodged or Dislocated (2923)
Health Effect - Clinical Code Embolism/Embolus (4438)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the patient's atrial leadless pacemaker (alp) dislodged.Further information was not provided.
 
Additional Manufacturer Narrative
Further information was requested but not received.
 
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Brand Name
AVEIR AR 2 Leadless Pacemaker
Common Device Name
Leadless Pacemaker
Manufacturer (Section D)
Abbott Medical (CRM-Sylmar)
15900 valley view court
sylmar CA 91342
Manufacturer (Section G)
Abbott Medical (CRM-Sylmar)
15900 valley view court
sylmar CA 91342
Manufacturer Contact
navpreet singh
15900 valley view court
sylmar, CA 91342
MDR Report Key50915503
Report Number2017865-2026-20507
Device Sequence Number5330472
Product Code PNJ
UDI-Device Identifier05415067051189
UDI-Public(01)05415067051189(10)S000111615(17)280216
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P150035
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare Professional
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 Model NumberLSP203A
Device Catalogue NumberLSP203A
Device Lot NumberS000111615
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/12/2026
Initial Report FDA Received Date09/28/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/16/2026
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 Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
Aveir DR Pacer
Patient SexMale
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