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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); Application Program Freezes or Fails to Launch (4031)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/09/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Continuation of d10: section d information references the main component of the system.Other relevant device(s) are: product id: 9735416, ubd: unknown, udi#: unknown.H3, h6: no products have been returned to medtronic for analysis.Codes b17, c20, and d15 are applicable.A13: applicable to the patient data not being read when a cd was inserted.A110201: applicable to system sometimes freezing during use.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 outside of a procedure.It was reported that before a functional endoscopic sinus surgery (fess) case, the patient data was not being read when a cd was inserted.Restarting the system may occasionally restore functionality.Additionally, the system sometimes froze during use.There was no patient involvement.
 
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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 Key22346242
Report Number1723170-2025-02511
Device Sequence Number8527497
Product Code HAW
UDI-Device Identifier00763000235079
UDI-Public00763000235079
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K001284
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 06/27/2025
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? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/10/2025
Initial Report FDA Received Date06/27/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured06/26/2018
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
"SEE H11...."
Patient SexUnknown
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