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U.S. Department of Health and Human Services

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

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MEDTRONIC NAVIGATION, INC. (BOXBOROUGH) O-ARM O2 IMAGING SYSTEM; INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM Back to Search Results
Model Number BI70002000
Medical Device Problem Code Incorrect, Inadequate or Imprecise Result or Readings (1535)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/21/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(h3, h6): no parts have been received by manufacturer for evaluation.Continuation of d10: section d information references the main component of the system.Other relevant device(s) are: product id: m021083c001, serial/lot #: (b)(6).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 for a cervical spine procedure.It was reported that an alleged inaccuracy on the system.Representative(rep) reported they were using infinity instruments and the pointer seemed to be accurate but the spine instruments were allegedly inaccurate.Rep reported the instruments were alleged inaccurate in sagittal view, either superior or inferior.Rep reported doctor aborted navigation and free handed for the continuation of case.This was occurred intra operatively.There was a patient present and reported delay of less than 1hour.No additional information was provided.
 
Additional Manufacturer Narrative
Additional info: updated a4.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
Additional information received "no impact on patient outcome".
 
Additional Manufacturer Narrative
Additional info: updated b5 and annex f code (f26).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.
 
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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. (BOXBOROUGH)
200 beaver brook rd
boxborough,ma 45640
MX  45640
Manufacturer (Section G)
MEDTRONIC NAVIGATION, INC. (BOXBOROUGH)
200 beaver brook rd
boxborough,ma 45640
MX   45640
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key22836531
Report Number3004785967-2025-00561
Device Sequence Number21144041
Product Code OWB
UDI-Device Identifier00763000068097
UDI-Public(01)00763000068097(11)180829
Combination Product (Y/N)N
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
K200074
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date (Section B) 09/11/2025
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
Device Lot Number-
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 07/21/2025
Supplement Date Received by Manufacturer08/19/2025
08/19/2025
Initial Report FDA Received Date08/19/2025
Supplement Report FDA Received Date09/11/2025
09/11/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured08/29/2018
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 Age62 YR
Patient SexFemale
Patient Weight68 KG
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