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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC PUERTO RICO OPERATIONS CO. PERCEPT; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINS

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MEDTRONIC PUERTO RICO OPERATIONS CO. PERCEPT; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINS Back to Search Results
Model Number B35200
Medical Device Problem Code Migration or Expulsion of Device (1395)
Health Effect - Clinical Codes Neck Stiffness (2434); Insufficient Information (4580)
Date of Event 09/25/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that patient bent downwards to grab something and heard a little click.Caller states it looks like the implant is a little further out.Caller is wondering if they should take the patient to the emergency room.Agent asked caller to connect to the implant and caller was able to connect.Patient stated they feel like they can't move their neck and like something is pulling.Agent reviewed role of patient services and advised caller to seek medical care if they are concerned with situation.Caller stated they tried to get a hold of health care provider but couldn't get through.
 
Additional Manufacturer Narrative
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.
 
Additional Manufacturer Narrative
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 was received from a healthcare professional (hcp).The hcp reported that the cause is not known.It is unknown if the issue is resolved.
 
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Brand Name
PERCEPT
Common Device Name
STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINS
Manufacturer (Section D)
MEDTRONIC PUERTO RICO OPERATIONS CO.
road 31, km. 24, hm 4
ceiba norte industrial park
juncos PR 00777
Manufacturer (Section G)
MEDTRONIC PUERTO RICO OPERATIONS CO.
road 31, km. 24, hm 4
ceiba norte industrial park
juncos PR 00777
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key23300266
Report Number3004209178-2025-17440
Device Sequence Number11984444
Product Code MHY
UDI-Device Identifier00763000420987
UDI-Public(01)00763000420987(17)221128
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P960009
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2022
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 11/12/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Expiration Date11/28/2022
Device Model NumberB35200
Device Catalogue NumberB35200
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 09/25/2025
Supplement Date Received by Manufacturer10/28/2025
Initial Report FDA Received Date10/15/2025
Supplement Report FDA Received Date11/12/2025
Date Device Manufactured12/07/2020
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient Age43 YR
Patient SexMale
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