MAUDE Adverse Event Report: SANMINA -SCI SYSTEMS O-ARM O2 IMAGING SYSTEM; INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM

Model Number	BI70002000
Medical Device Problem Codes	Failure to Advance (2524); Application Program Freezes or Fails to Launch (4031)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	02/12/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
H3, h6) the manufacture representative went to the site to test the imaging system and upon arrival the system had no power.Further troubleshooting revealed that the system had no motion, the image acquisition system personal computer had no power and the charger had multiple disabled cards.Troubleshot and replaced the power conversion as the brick was not illuminated.Also replaced the charget enclosure and now the system performs as intended.Performed system checkout as per user manual.Continuation of d10: section d information references the main component of the system.Other relevant device(s) are: product id: bi71000163r, product id: bi71000162r, product id: bi71000860r, product id: bi71000860r, product id: bi71000175r, product id: bi71000398, mdr codes: b01, c02, d02.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
Medtronic received information regarding an imaging system being used outside of a procedure.It was reported that the pendant screen of the system was black (pendant issues), the system was unable to drive, and there was no motion.It was confirmed that no patient was involved.
Additional Manufacturer Narrative
The power conversion enclosure was returned to the manufacturer for analysis.Analysis found that unable to confirm reported complaint.The power conversion enclosure passed bench testing.Install into test system.The system booted, motion, x-ray and communication all readied on every power up.All 2d and 3d images and motion functions were successful.No fault found while under test.B19, d14 are applicable continuation of d10: section d information references the main component of the system.Other relevant device(s) are: product id: bi71000860r, serial/lot #: (b)(6) rev.A 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.
Additional Manufacturer Narrative
(h3,h6): the charger enclosure was returned to the manufacturer for evaluation.After functional testing and visual/physical examination, the reported issue was not confirmed.Visual inspection confirm charger cards missing charger cards alignment pin.Codes: b01, c02, d02 codes are applicable.Continuation of d10: section d information references the main component of the system.Other relevant device(s) are: product id: bi71000175r, serial/lot #: ,(b)(6) rev.8 ubd: , udi#: 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.

• Brand Name: O-ARM O2 IMAGING SYSTEM
• Common Device Name: INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM
• Manufacturer (Section D): SANMINA -SCI SYSTEMS; km 15.5 no. 29, plant 06; carr. chapala-guadalajara,jal 45640 ; MX 45640
• Manufacturer (Section G): SANMINA -SCI SYSTEMS; km 15.5 no. 29, plant 06; carr. chapala-guadalajara,jal 45640 ; MX 45640
• Manufacturer Contact: justin ellis ; 8200 coral sea street ne mvs21; mounds view, MN 55112 ; 7635265677
• MDR Report Key: 21502779
• Report Number: 3006544299-2025-00224
• Device Sequence Number: 12767663
• Product Code: OWB
• UDI-Device Identifier: 00763000584115
• UDI-Public: 00763000584115
• Combination Product (Y/N): N
• Initial Reporter State: CO
• Initial Reporter Country: US
• PMA/510(K) Number: K200074
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 04/09/2025

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 Number: BI70002000
• Device Catalogue Number: BI70002000
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 02/12/2025
• Supplement Date Received by Manufacturer: 03/17/2025; 03/24/2025
• Initial Report FDA Received Date: 03/03/2025
• Supplement Report FDA Received Date: 03/20/2025; 04/09/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 02/20/2023
• 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 Number: 1
• Patient Sex: Unknown