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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC, INC. CARELINK PROGRAMMER; PROGRAMMER, PACEMAKER

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MEDTRONIC, INC. CARELINK PROGRAMMER; PROGRAMMER, PACEMAKER Back to Search Results
Model Number 2090
Medical Device Problem Code Overheating of Device (1437)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/15/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product analysis :analysis was unable to confirm the customer comment that the programmer was releasing smoke after being turned on, however it was noted that there was a burning odour emanating from the programmer and it was unable to power up.It was further noted that the power supply was pulling apart and the link electronic module (lem) failed functional testing.All found defective parts were replaced and all other identified issues were resolved.Reconfigured hard drive, reloaded and updated software and the programmer then passed all final functional and systems tests.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.
 
Event or Problem Description
It was reported that the programmer released smoke when turned on.There was no patient involvement.
 
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Brand Name
CARELINK PROGRAMMER
Common Device Name
PROGRAMMER, PACEMAKER
Manufacturer (Section D)
MEDTRONIC, INC.
8200 coral sea street ne
mounds view MN 55112
Manufacturer (Section G)
MEDTRONIC, INC.
8200 coral sea street ne
mounds view MN 55112
Manufacturer Contact
gerard torenvliet
8200 coral sea st ne
mounds view, MN 55112
7635269277
MDR Report Key19530320
Report Number2182208-2024-02451
Device Sequence Number18017684
Product Code KRG
UDI-Device Identifier00613994581570
UDI-Public00613994581570
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
P890003
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 06/13/2024
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 Other
Device Model Number2090
Device Catalogue Number2090
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/20/2024
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/15/2024
Initial Report FDA Received Date06/13/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/28/2011
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
2067 RADIOFREQUENCY HEAD, 229047 ANALYZER,
Patient SexUnknown
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