SMART MONITOR

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2019-12-05 for SMART MONITOR manufactured by Manufactured For Microport Crm S.r.l..

Event Text Entries

[177369690] Reportedly, during first installation for association with an icd, the status led of the subject home monitor remains orange. It did not react to any health check.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1000165971-2019-00668
MDR Report Key9414896
Report SourceCOMPANY REPRESENTATIVE
Date Received2019-12-05
Date of Report2020-03-20
Date of Event2019-11-13
Date Facility Aware2019-11-13
Date Mfgr Received2020-02-24
Date Added to Maude2019-12-05
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactLAURA OUAKI
Manufacturer StreetPARC D'AFFAIRES NOVEOS 4 AVENUE R .
Manufacturer CityCLAMART, 92140 92140
Manufacturer CountryFR
Manufacturer Postal92140
Manufacturer Phone146013429
Manufacturer G1EOLANE BLD J. BAPTISTE COLBERT 49520 COMBREE FRANCE
Manufacturer StreetPARC D'AFFAIRES NOVEOS 4 AVENUE R .
Manufacturer CityCLAMART, 92140 92140
Manufacturer CountryFR
Manufacturer Postal Code92140
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSMART MONITOR
Generic NamePACEMAKER/ICD/CRT NON-IMPLANTED COMPONENTS
Product CodeOSR
Date Received2019-12-05
Returned To Mfg2019-11-18
Model NumberSMART MONITOR
Catalog NumberSMART MONITOR
OperatorLAY USER/PATIENT
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerMANUFACTURED FOR MICROPORT CRM S.R.L.
Manufacturer AddressPARC D'AFFAIRES NOVEOS 4 AVENUE R?AUMUR . CLAMART, 92140 92140 FR 92140


Patients

Patient NumberTreatmentOutcomeDate
10 2019-12-05

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