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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC. FUSION COMPACT; EAR, NOSE, AND THROAT STEREOTAXIC INSTRUMENT

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MEDTRONIC NAVIGATION, INC. FUSION COMPACT; EAR, NOSE, AND THROAT STEREOTAXIC INSTRUMENT Back to Search Results
Model Number 9735602
Medical Device Problem Code Display or Visual Feedback Problem (1184)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/25/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Section d references the main component of the system.Other medical products in use during the event include: product id: 9735602 h3: no parts have been received by the manufacturer for evaluation.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 screen was black.There was no patient involvement.Troubleshooting was performed.It was confirmed the cd/dvd drive opened, and green light was on the compact.The green light on the power cord brick was on.The site moved power outlets with no resolution.
 
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Brand Name
FUSION COMPACT
Common Device Name
EAR, NOSE, AND THROAT 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 Key23658951
Report Number1723170-2025-03818
Device Sequence Number18672893
Product Code PGW
UDI-Device Identifier00643169672956
UDI-Public(01)00643169672956(11)170726(10)1940636
Combination Product (Y/N)N
Initial Reporter StatePA
Initial Reporter CountryUS
PMA/510(K) Number
K153247
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 11/26/2025
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 Number9735602
Device Catalogue Number9735602
Device Lot Number1940636
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 11/25/2025
Initial Report FDA Received Date11/26/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/26/2017
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 SexUnknown
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