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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC (LITTLETON) O-ARM O2 IMAGING SYSTEM; INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM

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MEDTRONIC NAVIGATION, INC (LITTLETON) O-ARM O2 IMAGING SYSTEM; INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM Back to Search Results
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 08/30/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3) the manufacturer representative went to the site to test the imaging system.The gantry door was not aligned.The site stated that the gantry was not opening.Before arriving the site stated that the gantry might have been clipped on the bed.The cover had a chipped.They performed a rotor offset calibration and ran encoder slipping commands.Rotor did not slip and returned to home.Inspected the system and did a checkout of system.All passed.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.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 in an unknown procedure.It was reported that the site could not open the gantry while it was around a patient.The site tried rebooting and using the yellow button to open the gantry, but the system did not respond.It was reported that the system became unresponsive after a spin, and the screen went black.It is unknown if there was a delay to the procedure, and if there was an impact to the patient.Additional information was received.There was no impact to the patient's outcome.
 
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Brand Name
O-ARM O2 IMAGING SYSTEM
Common Device Name
INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM
Manufacturer (Section D)
MEDTRONIC NAVIGATION, INC (LITTLETON)
300 foster st
littleton MA 01460
Manufacturer (Section G)
MEDTRONIC NAVIGATION, INC (LITTLETON)
300 foster st
littleton MA 01460
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key22364467
Report Number3004785967-2025-00405
Device Sequence Number9436511
Product Code OWB
UDI-Device Identifier00763000584115
UDI-Public(01)00763000584115(11)220906
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
K200074
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 06/30/2025
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 NumberBI70002000
Device Catalogue NumberBI70002000
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 06/11/2025
Initial Report FDA Received Date06/30/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/06/2022
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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