MAUDE MDR 25341012

MDR report key
25341012
Report number
3008973940-2026-04089
Event key
0
Event type
3
Date of event
2026-05-08
Date received
2026-05-31
Adverse event
1
Product problem
0
Patients in event
0
Reporter occupation
1
Health professional
1
Initial report to FDA
0
Event location
0

Manufacturer Contact#

Contact
GERARD TORENVLIET
Address
8200 CORAL SEA ST NE MOUNDS VIEW MN 55112 US
Phone
763-763-7635
Report source
M

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
150228SPRINT QUATTRO SECURE S MRI SURESCANIMPLANTABLE CARDIOVERTER DEFIBRILLATOR (NON-CRT)MEDTRONIC SINGAPORE OPERATIONSLWS6935M626935M62*N
288057SPRINT QUATTRO SECURE S MRI SURESCANIMPLANTABLE CARDIOVERTER DEFIBRILLATOR (NON-CRT)MEDTRONIC SINGAPORE OPERATIONSLWS6935M626935M62*N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12026-05-310R; H

Event Narratives#

N

Patient 0

MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

D

Patient 0

IT WAS REPORTED THAT THE IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) SYSTEM WAS EXPLANTED DUE TO POCKET INFECTION. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.