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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC PUERTO RICO VILLALBA SENSIGHT; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINS

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MEDTRONIC PUERTO RICO VILLALBA SENSIGHT; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINS Back to Search Results
Model Number B3300542M
Medical Device Problem Code Material Twisted/Bent (2981)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/21/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the end (distal brain contact end) of the lead was slightly bent out of the box prior to use.No environmental, external, or patient factors were identified as contributing to the issue.The product was never implanted.No diagnostics or troubleshooting were performed.A replacement lead was provided.No patient complications have been reported as a result of this event.
 
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
See h.11.
 
Additional Manufacturer Narrative
Product analysis #708719403:analysis information -- 2026-02-23 10:37:05 cst pli# 10 product id# b3300542m the returned device was subjected to a series of standard tests that include but is not limited to visual inspection and electrical testing.The measured distal end straightness of the returned lead was below the upper specification limit with and without the stylet inserted.Accordingly, the returned lead met the acceptance criteria and passed the distal end straightness test.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
SENSIGHT
Common Device Name
STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINS
Manufacturer (Section D)
MEDTRONIC PUERTO RICO VILLALBA
road 149 km 56.3
villalba PR 00766
Manufacturer (Section G)
MEDTRONIC PUERTO RICO VILLALBA
road 149 km 56.3
villalba PR 00766
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key23637420
Report Number2649622-2025-33055
Device Sequence Number9988268
Product Code MHY
UDI-Device Identifier00763000426408
UDI-Public(01)00763000426408(17)270916
Combination Product (Y/N)N
Initial Reporter StateGA
Initial Reporter CountryUS
PMA/510(K) Number
P960009
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (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) 02/23/2026
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 NumberB3300542M
Device Catalogue NumberB3300542M
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/21/2025
Supplement Date Received by Manufacturer02/03/2026
02/23/2026
Initial Report FDA Received Date11/24/2025
Supplement Report FDA Received Date02/20/2026
02/23/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/16/2025
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 SexMale
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