| Brand Name | EMBOSHIELD NAV6 |
| Common Device Name | Temporary Carotid Catheter for Embolic Capture |
| Manufacturer (Section D) |
| ABBOTT VASCULAR INC. |
| 3200 lakeside drive |
| santa clara CA 95054 -280 |
|
| Manufacturer (Section G) |
| ABBOTT VASCULAR, Reg # 2024168 |
| 26531 ynez road |
|
| temecula CA 92591 -462 |
|
| Manufacturer Contact |
|
lindsey
bell
|
| 26531 ynez rd. |
| temecula, CA 92591--462
|
|
+1(951)914-5259
|
|
| MDR Report Key | 50949636 |
| Report Number | 2024168-2026-03794 |
| Device Sequence Number | 16065288 |
| Product Code |
NTE
|
| UDI-Device Identifier | 08717648137747 |
| UDI-Public | (01)08717648137747(17)290531(10)6062561 |
| Combination Product (Y/N) | N |
| Initial Reporter State | IL |
| Initial Reporter Country | US |
| PMA/510(K) Number | K191173 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| 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? |
Yes
|
| Operator of Device |
Health Professional
|
| Device Model Number | 22437-19 |
| Device Catalogue Number | 22437-19 |
| Device Lot Number | 6062561 |
| 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 | 09/08/2026 |
| Initial Report FDA Received Date | 09/30/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 06/25/2026 |
| 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 |
Required Intervention;
|
| Patient Sex | Unknown |