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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC (LITTLETON) O-ARM O2 IMAGING SYSTEM; INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM

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MEDTRONIC NAVIGATION, INC (LITTLETON) O-ARM O2 IMAGING SYSTEM; INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM Back to Search Results
Model Number BI70002000
Device Problem Smoking (1585)
Patient Problem No Patient Involvement (2645)
Event Date 08/01/2019
Event Type  malfunction  
Manufacturer Narrative
A medtronic representative went to the site to test the equipment.Testing revealed that there was a burnt battery.The battery tray was replaced.The imaging system then passed the system checkout and was found to be fully functional.No parts have been received by the manufacturer for evaluation.If information is provided in the future, a supplemental report will be issued.
 
Event Description
Medtronic received information regarding an imaging system.It was reported that the site smelled a burning battery smell.A manufacturer representative told the site to unplug the system from the outlet.There was no patient present when this issue was identified.
 
Manufacturer Narrative
Additional information: an update was provided from the field service engineer that a battery tray was leaking and burned a little bit.Two battery trays have been received by the manufacturer.However, analysis has not been completed.If information is provided in the future, a supplemental report will be issued.
 
Manufacturer Narrative
Additional information: concomitant medical products: other relevant device(s) are: product id: bi71000162, serial/lot #: (b)(4) : s/n n/a, ubd: unknown, udi#: unknown.Product id: bi71000163, serial/lot #: (b)(4) : s/n n/a, ubd: unknown, udi#: unknown.The battery trays were returned to the manufacturer for analysis.Analysis found that the reported issue could be confirmed.Visual inspection noted scuffs and scratches consistent with normal use.On one tray, the first battery exhibits expansion and the positive terminal was raised.The second battery exhibited melting and eos at the seam.Bench testing was performed at normal room temperature.The battery pair measured 13.17vdc and 13.14vdc (eos battery).Total voltage measured 26.31vdc.Tested all fuses, passed continuity testing.On the second tray, the third battery exhibits melting and eos at the seam.Bench testing was performed at normal room temperature.First battery pair measured 13.17vdc and 13.13vdc.The second battery pair measured 10.44vdc (eos battery) and 12.83vdc.Total voltage measured 49.58vdc.Tested all fuses, passed continuity testing.Analysis found that the reported event was related to an electrical issue.Medtronic is submitting this report to comply with fda reporting regulations under 21 cfr parts 4 and 803.This report is based upon information obtained by medtronic, which the company may not have been able to fully investigate or verify prior to the date the report was required by the fda.Medtronic has made reasonable efforts to obtain more complete information and has provided 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.In particular, this report does not constitute an admission by anyone that the product described in this report has any ¿defects¿ or has ¿malfunctioned¿.These words are included in the fda 3500a form and are fixed items for selection created by the fda to categorize the type of event solely for the purpose of regulatory reporting.Medtronic objects to the use of these words and others like them because of the lack of definition and the connotations implied by these terms.This statement should be included with any information or report disclosed to the public under the freedom of information act.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.A good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.
 
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Brand Name
O-ARM O2 IMAGING SYSTEM
Type of Device
INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM
Manufacturer (Section D)
MEDTRONIC NAVIGATION, INC (LITTLETON)
300 foster st
littleton MA 01460
MDR Report Key8864270
MDR Text Key153373802
Report Number3004785967-2019-01385
Device Sequence Number1
Product Code OWB
UDI-Device Identifier00643169639683
UDI-Public00643169639683
Combination Product (y/n)N
PMA/PMN Number
K151000
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Type of Report Initial,Followup,Followup
Report Date 09/27/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/06/2019
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberBI70002000
Device Catalogue NumberBI70002000
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/12/2019
Date Manufacturer Received09/03/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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