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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC. PASSIVE PLANAR BLUNT PROBE; NEUROLOGICAL STEREOTAXIC INSTRUMENT

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MEDTRONIC NAVIGATION, INC. PASSIVE PLANAR BLUNT PROBE; NEUROLOGICAL STEREOTAXIC INSTRUMENT Back to Search Results
Model Number 960-556
Medical Device Problem Code Mechanical Problem (1384)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/11/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3: the passive planar probe, lot number: 160511, was returned to the manufacturer for analysis.The probe was found to have a bent tip.The tip of the returned probe was visibly bent.With markers attached and fully seated, the probe displays a high geometry error but a normal divot error.The support arms for markers #3 and #4 were slightly bent causing the high geometry error.H6: codes b01, c07, and d02 are applicable to the hardware 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 a navigation system being used outside of a procedure.It was reported that there was a damaged passive planar blunt-tip probe.There was no patient involvement.The damaged probe was not being used for a case, but was being stored in an s8 to be used for a non-sterile cranial registration.
 
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Brand Name
PASSIVE PLANAR BLUNT PROBE
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 Key23646270
Report Number1723170-2025-03808
Device Sequence Number10055679
Product Code HAW
UDI-Device Identifier00673978090122
UDI-Public(01)00673978090122(11)160511(10)160511
Combination Product (Y/N)N
Initial Reporter StateWI
Initial Reporter CountryUS
PMA/510(K) Number
K972398
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 11/25/2025
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 Number960-556
Device Catalogue Number960-556
Device Lot Number160511
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/20/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/20/2025
Initial Report FDA Received Date11/25/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/11/2016
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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