| Brand Name | Jewel |
| Common Device Name | Wearable Cardioverter Defibrillator |
| Manufacturer (Section D) |
| Element Science, Inc. |
| 301 chesapeake drive |
| redwood city CA 94063 |
|
| Manufacturer (Section G) |
| Element Science, Inc. |
| 301 chesapeake drive |
|
| redwood city CA 94063 |
|
| Manufacturer Contact |
|
vis
ayer
|
| 301 chesapeake drive |
| redwood city, CA 94063
|
|
+1(415)872-6500
|
|
| MDR Report Key | 50954715 |
| Report Number | 3027605722-2026-00009 |
| Device Sequence Number | 10446107 |
| Product Code |
MVK
|
| UDI-Device Identifier | 00850047782007 |
| UDI-Public | 00850047782007 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | US |
| PMA/510(K) Number | P230022 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Consumer |
| Remedial Action |
Replace |
| 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? |
No
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Lay User/Patient
|
| Device Expiration Date | 03/09/2026 |
| Device Model Number | ES-2 |
| Device Catalogue Number | JWL-1-MDU0-E01 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 03/05/2026 |
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 03/05/2026 |
| Initial Report FDA Received Date | 09/30/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 10/09/2025 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
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 |
| Patient Age | 69 YR |
| Patient Sex | Male |
|
|