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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC PUERTO RICO OPERATIONS CO. SURESCAN; STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR

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MEDTRONIC PUERTO RICO OPERATIONS CO. SURESCAN; STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR Back to Search Results
Model Number 97714
Device Problems Overheating of Device (1437); Use of Device Problem (1670); Delayed Charge Time (2586); Malposition of Device (2616); Charging Problem (2892); Communication or Transmission Problem (2896)
Patient Problems Pain (1994); Burning Sensation (2146); No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Event Description
Information was received from a manufacturer representative regarding a patient who was implanted with an implantable neurostimulator (ins) for spinal pain indications.Caller met with patient today and patient reported issues with communicating to ins with patient programmer (pp).Patient uses the antenna and has to apply pressure to get the pp and ins to communicate.Caller noted the ins is pretty superficial, she could feel the ins.Caller does not know if the pp worked better without the antenna.Caller met with patient and was told patient recharger paddle gets very hot while charging.No known error codes or messages noted on the recharger (insr).Caller will have patient contact patient services with equipment for additional troubleshooting/replacement.Additional information was received from a manufacturer representative (rep).It was reported that the issue reported was related to the patient programmer and ins communication.The patient reported that he has to apply significant pressure over implant site for the pp to communicate with ins.Having to apply this pressure requires getting into compromising positions for shoulders and lb and causes pain.They reported that the ins feels ¿somewhat¿ superficial, but not as superficial as when the device was first implanted.He reported weight fluctuations and recalls that the superficiality is directly related to his weight but does not relate to the communication issues.Pt will be contacting patient services to acquire refurbished pp and recharger to rule out any errors on that end.This information was also confirmed with a physician/account.Additional information was received.It was reported that they had issues with both the recharger and the pt programmer connecting to the implantable neurostimulator (ins).Pt said the recharger did not have coupling bars when charging their ins unless they put a lot of pressure on the recharger antenna against their ins.Pt said they actually put a rolled up towel against the recharger antenna and lay on the towel against their back and still the pt never g ot the "full 10 bars." pt mentioned the recharge time was close to 8 hours and the recharger antenna got hot to the touch.Pt mentioned they got "no bars without pressure" and the right spot for connectivity on their back was just left of the ins.Pt also said they had issues with the connection of the pt programmer.Pt said "it was almost impossible to get connectivity." pt said they had to place the pt programmer antenna against their back and lean into the antenna and press real hard to get the antenna to connect to the ins.Pt said sometimes they had to press the sync button 6-9 times before they could get the ins connected to the antenna.Pt said issues occurred both with and without the pt programmer antenna attached.Issue with pt programmer also started "a long time ago." the pt spoke to a manufacturer representative (rep) and the rep said the pt should call pats and have their equipment replaced before the pt considered doing anything "medical".A replacement programmer antenna, programmer, and recharger antenna were sent out.Rep responded back and reported that they heard back from the patient and confirmed that the connectivity issue of the pt programmer to the ins has been resolved.He said the pt programmer has ¿excellent connectivity¿, but he still needs time to assess the recharger antenna.Rep will follow up with more updates as soon as they hear them.
 
Manufacturer Narrative
Continuation of d10: product id 97740 lot# serial# (b)(6) implanted: explanted: product type programmer, patient product id 37791 lot# serial# unknown implanted: explanted: product type recharger product id 37092 lot# serial# unknown implanted: explanted: product type multiple therapy product section d information references the main component of the system.Other relevant device(s) are: product id: 37791, serial/lot #: unknown, ubd: , udi#: this regulatory report is being submitted as part of a retrospective review as part of remediation plan 411 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.
 
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Brand Name
SURESCAN
Type of Device
STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR
Manufacturer (Section D)
MEDTRONIC PUERTO RICO OPERATIONS CO.
road 31, km. 24, hm 4
ceiba norte industrial park
juncos PR 00777
Manufacturer (Section G)
MEDTRONIC PUERTO RICO OPERATIONS CO.
road 31, km. 24, hm 4
ceiba norte industrial park
juncos PR 00777
Manufacturer Contact
glen belmer
7000 central avenue ne rcw215
minneapolis, MN 55432
6122713209
MDR Report Key18951081
MDR Text Key338997964
Report Number3004209178-2024-07521
Device Sequence Number1
Product Code LGW
UDI-Device Identifier00643169109483
UDI-Public00643169109483
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P840001
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Consumer,Company Representative
Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date 03/21/2024
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
Device Operator Health Professional
Device Expiration Date09/14/2017
Device Model Number97714
Device Catalogue Number97714
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 08/23/2022
Initial Date FDA Received03/21/2024
Date Device Manufactured10/25/2016
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient SexMale
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