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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 Code Failure to Advance (2524)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/26/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Section d references the main component of the system.Other medical products in use during the event include: brand name ; product id bi71000166 (lot: -); product type: 3022-door motion (o2) electrical co brand name ; product id bi71000166 (lot: -); product type: 3022-door motion (o2) electrical co h3: a manufacturer representative went to the site to test the equipment.In summary, the door did not close.The door switch was ch ecked.Two switches were replaced.The system performed as intended.Codes fdm b01, fdr c07, fdc d02 are applicable to this analysis.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 there was a door closing problem.There was no patient involvement.
 
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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 Key22384923
Report Number3004785967-2025-00424
Device Sequence Number8761244
Product Code OWB
UDI-Device Identifier00643169618121
UDI-Public(01)00643169618121(11)160321
Combination Product (Y/N)N
Initial Reporter CountryGM
PMA/510(K) Number
K200074
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 07/02/2025
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 06/27/2025
Initial Report FDA Received Date07/02/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/21/2016
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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