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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC FUSION® ENT NAVIGATION SYSTEM; NEUROLOGICAL STEREOTAXIC INSTRUMENT

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MEDTRONIC NAVIGATION, INC FUSION® ENT NAVIGATION SYSTEM; NEUROLOGICAL STEREOTAXIC INSTRUMENT Back to Search Results
Model Number 9733560
Medical Device Problem Codes Communication or Transmission Problem (2896); Delayed Program or Algorithm Execution (4034)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/16/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3) a manufacturer representative (rep) went to the site to test the navigation system.The database was cleaned in order to speed up process handling operations.The rep instructed the site that the most effective way to download examination would be to connect the device to the hospital electronic picture archiving and communication systems (pacs) network.Codes: b01, c13, d07.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 a navigation system being used in an unknown context.It was reported that the system was slow updating results of tests.Patient presence unknown.No further information available.Additional information was received.The issue occurred before planning the surgery with no patient present.The system had problems reading patient images from the disk.The site was preparing for a functional endoscopic sinus surgery (fess) procedure and it was able to be completed.There was no surgical delay.
 
Additional Manufacturer Narrative
H2) additional review of the event information showed that there was no information to reasonably suggest that the device in this report may have cause or contributed to a death or serious injury or that the device in this report has malfunctioned.Therefore, this event did not and does not meet the reporting requirements in 21 cfr 803.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
The event was made reportable due to an allegation of problems reading the disk.After further review, it was determined the problem was the previously mentioned slow performance, not that the disk was unable to be read at all which does not meet reporting criteria.
 
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Brand Name
FUSION® ENT NAVIGATION SYSTEM
Common Device Name
NEUROLOGICAL STEREOTAXIC INSTRUMENT
Manufacturer (Section D)
MEDTRONIC NAVIGATION, INC
826 coal creek circle
louisville CO 80027
Manufacturer (Section G)
MEDTRONIC NAVIGATION, INC
826 coal creek circle
louisville CO 80027
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key22195363
Report Number1723170-2025-02299
Device Sequence Number9311006
Product Code HAW
UDI-Device Identifier00643169504394
UDI-Public00643169504394
Combination Product (Y/N)N
Initial Reporter CountryPL
PMA/510(K) Number
K001284
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 06/19/2025
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 Number9733560
Device Catalogue Number9733560
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/16/2025
Supplement Date Received by Manufacturer06/19/2025
Initial Report FDA Received Date06/12/2025
Supplement Report FDA Received Date06/19/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/05/2015
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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