FDA Adverse Event
Malfunction
Summary report: N
THE GUARDIAN SYSTEM
MDR report key: 21834868
·
Received April 14, 2025
Report
- Report Number
- 3017374019-2025-00022
- Event Type
- Malfunction
- Date Received
- April 14, 2025
- Date of Event
- September 5, 2024
- Report Date
- April 14, 2025
- Manufacturer
- AVERTIX MEDICAL INC
- Product Code
- QBI
- PMA / PMN Number
- P150009
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- BIOMEDICAL ENGINEER
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
PREMATURE IMD ERI/EOS. THIS IS ONE OF THE 25 DEVICES THAT HAD THIS ISSUE WITH PREMATURE BATTERY DEPLETION. THIS MDR IS BEING FILED RETROACTIVELY AT THE REQUEST OF CDRH AND OII AFTER A FEB. 2025 INSPECTION. AVERTIX PERFORMED A VOLUNTRAY RECALL/CORRECTION FOR THIS ISSUE IN 2023.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1022824 | THE GUARDIAN SYSTEM | GUARDIAN | QBI | AVERTIX MEDICAL INC | AMSG3-E | 121720V0209530000037 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 67 YR | Male | Required Intervention |