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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC. EM INSTRUMENT TRACKER; NEUROLOGICAL STEREOTAXIC INSTRUMENT

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MEDTRONIC NAVIGATION, INC. EM INSTRUMENT TRACKER; NEUROLOGICAL STEREOTAXIC INSTRUMENT Back to Search Results
Model Number 9733533
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 11/17/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3).No hardware parts have been received by the manufacturer for evaluation.Codes: b17, c20, and d15.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 the tracker clearly indicated a position that was misaligned.It was changed to a different tracker and progressed without any problems.There was no patient involvement.
 
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Brand Name
EM INSTRUMENT TRACKER
Common Device Name
NEUROLOGICAL STEREOTAXIC INSTRUMENT
Manufacturer (Section D)
MEDTRONIC NAVIGATION, INC.
200 medtronic drive
lafayette CO 80027
Manufacturer (Section G)
MEDTRONIC NAVIGATION, INC.
200 medtronic drive
lafayette CO 80027
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key23617782
Report Number1723170-2025-03786
Device Sequence Number9051510
Product Code HAW
UDI-Device Identifier00613994353450
UDI-Public(01)00613994353450(17)270807(10)250807F(20)01
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K001284
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (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) 11/21/2025
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 Number9733533
Device Catalogue Number9733533
Device Lot Number250807F
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 11/18/2025
Initial Report FDA Received Date11/21/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured08/07/2025
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
Concomitant Medical Products
and Therapy/Usage Dates
SEE H11
Patient SexUnknown
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