| Brand Name | Azure XT DR MRI SureScan |
| Common Device Name | PULSE GENERATOR, PERMANENT, IMPLANTABLE |
| Manufacturer (Section D) |
| Medtronic Singapore Operations |
| 49 changi south avenue 2 |
| nasaco tech centre |
| singapore 48605 6 |
| SN 486056 |
|
| Manufacturer (Section G) |
| Medtronic Singapore Operations |
| 49 changi south avenue 2 |
| nasaco tech centre |
| singapore 48605 6 |
|
SN
486056
|
|
| Manufacturer Contact |
|
gerard
torenvliet
|
| 8200 coral sea st ne |
| mounds view, MN 55112--439
|
|
+1(763)526-9277
|
|
| MDR Report Key | 50946046 |
| Report Number | 3008973940-2026-07301 |
| Device Sequence Number | 16059620 |
| Product Code |
NVZ
|
| UDI-Device Identifier | 00763000316846 |
| UDI-Public | (01)00763000316846(17)270828 |
| Combination Product (Y/N) | N |
| Initial Reporter State | CA |
| Initial Reporter Country | US |
| PMA/510(K) Number | P980035 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2026 |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/30/2026 |
| 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 |
Lay User/Patient
|
| Device Model Number | W1DR01 |
| Device Catalogue Number | W1DR01 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 09/11/2026 |
| Initial Report FDA Received Date | 09/30/2026 |
| Date Device Manufactured | 03/11/2026 |
| 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 Number | 1 |
| Outcome Attributed to Adverse Event |
Hospitalization;
Required Intervention;
|
| Patient Sex | Female |