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U.S. Department of Health and Human Services

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

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MEDTRONIC, INC. PROGRAMMING HEAD; PROGRAMMER, PACEMAKER Back to Search Results
Model Number 2067
Medical Device Problem Code Electrical Shorting (2926)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/28/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product analysis: analysis was able to confirm the customer's comment that the programmer spontaneously shut down after plugging the radiofrequency (rf) head.It was noted that the rf head had a short circuit.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 radiofrequency(rf) head had a short circuit that caused the programmer to shut down.It was noted that the programmer functioned normally when rf head is disconnected.There was no patient involvement.
 
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Brand Name
PROGRAMMING HEAD
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 55112-4391
7635269277
MDR Report Key22050661
Report Number2182208-2025-02448
Device Sequence Number9095461
Product Code KRG
UDI-Device Identifier00613994362896
UDI-Public00613994362896
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
P890003
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 05/20/2025
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 Other
Device Model Number2067
Device Catalogue Number2067
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/28/2024
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/28/2025
Initial Report FDA Received Date05/20/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/26/2010
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
Patient SexUnknown
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