MAUDE Adverse Event Report: MEDTRONIC MED REL MEDTRONIC PUERTO RICO ACTIVA; IMPLANTED SUBCORTICAL ELECTRICAL STIMULATOR (MOTOR DISORDERS)

Model Number 37601

Device Problem Premature Discharge of Battery (1057)

Patient Problems Pain (1994); Dysphasia (2195); Complaint, Ill-Defined (2331); Ambulation Difficulties (2544)

Event Type  Injury  

Event Description

A consumer whose indication for use is dystonia and movement disorders reported they were implanted in (b)(6) 2011, just a little over 5 years prior and they had already had two battery replacements.They had been told the battery would last 5-7 years but had only lasted about a year and a half.The last battery replacement had been in (b)(6) 2014.The patient had lost a lot of time at work because they were either unable to drive and/or stand and speak coherently.The patient needed the device to be able to live a kind of normal life.The patient was always in pain.Without the device the patient's head violently twists to the left, they have a hard time with balance, fall down stairs, run into things, their speech is affected in that they slur words and double talk often making it difficult to work because communication was a big part of their job as well as standing and moving, also driving was near impossible.With the device the patient can work, drive and live a reasonably normal life.

Manufacturer Narrative

If information is provided in the future, a supplemental report will be issued.

• Brand Name: ACTIVA
• Type of Device: IMPLANTED SUBCORTICAL ELECTRICAL STIMULATOR (MOTOR DISORDERS)
• Manufacturer (Section D): MEDTRONIC MED REL MEDTRONIC PUERTO RICO; ceiba norte industrial park, r; juncos PR 00777
• Manufacturer (Section G): MEDTRONIC MED REL MEDTRONIC PUERTO RICO; ceiba norte industrial park, r; juncos PR 00777
• Manufacturer Contact: diane wolf ; 7000 central avenue ne rcw215; minneapolis, MN 55432 ; 7635263987
• MDR Report Key: 5544571
• MDR Text Key: 41763540
• Report Number: 3004209178-2016-05966
• Device Sequence Number: 1
• Product Code: MRU
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: H020007
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: consumer
• Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date: 04/04/2016

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 Date: 03/28/2014
• Device Model Number: 37601
• Device Catalogue Number: 37601
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Initial Date Manufacturer Received: 03/24/2016
• Initial Date FDA Received: 04/04/2016
• Supplement Dates Manufacturer Received: 03/24/2016
• Supplement Dates FDA Received: 09/21/2017
• Date Device Manufactured: 10/03/2012
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention