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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC I7 EQUIPMENT RACK; INSTRUMENT, STEREOTAXIC

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MEDTRONIC NAVIGATION, INC I7 EQUIPMENT RACK; INSTRUMENT, STEREOTAXIC Back to Search Results
Model Number 9734060
Medical Device Problem Codes Computer Operating System Problem (2898); Application Program Freezes or Fails to Launch (4031)
Health Effect - Clinical Code No Patient Involvement (2645)
Date of Event 06/12/2020
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Other relevant device(s) are: computer 9735226r rollingstone i7 rfrb.If information is provided in the future, a supplemental report will be issued.
 
Event or Problem Description
Medtronic received information regarding a navigation system used outside of procedure.It was reported that the system was very slow to boot up and was freezing while in the application.The clinical specialist (cs) had previously deleted patient exams and reinstalled the software.It was reported that the site keeps the system on 24/7 ad it was believed that the rack acts the same way.There was no patient present.
 
Additional Manufacturer Narrative
H2: initial reporter information was updated.See e1-e3.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.
 
Additional Manufacturer Narrative
H3: a medtronic representative went to the site to test the equipment.Testing revealed that the navigation system booted up slowly and also ran slower than anticipated.Patient data was removed, surgeon profiles were condensed and the software was uninstalled and re-installed.The system then passed the system checkout and was found to be fully functional.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.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.
 
Additional Manufacturer Narrative
H2: section g updated continuation of d11: section d information references the main component of the system.Other relevant device(s) are: product id: 9735585, serial/lot #: version: 3.1.1 h3:  a software analysis was initiated to determine the probable cause of the issue.Analysis found that the reported event was related to a software issue.This issue was documented in a medtronic navigation software anomaly tracking database.H6: 10,104,4315 are associated with software analysis 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
I7 EQUIPMENT RACK
Common Device Name
INSTRUMENT, STEREOTAXIC
Manufacturer (Section D)
MEDTRONIC NAVIGATION, INC
826 coal creek circle
louisville CO 80027
MDR Report Key10162077
Report Number1723170-2020-01681
Device Sequence Number2400880
Product Code HAW
UDI-Device Identifier00613994653482
UDI-Public00613994653482
Combination Product (Y/N)N
Initial Reporter StatePA
Initial Reporter CountryUS
PMA/510(K) Number
K050438
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source company representative
Initial Reporter Occupation Nurse
Type of Report Initial,Followup,Followup,Followup
Report Date (Section B) 10/02/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model Number9734060
Device Catalogue Number9734060
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/15/2020
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/12/2020
Supplement Date Received by Manufacturer06/17/2020
06/24/2020
10/01/2020
Initial Report FDA Received Date06/17/2020
Supplement Report FDA Received Date06/25/2020
07/07/2020
10/02/2020
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
"SEE H10...."; SEE H10
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