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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC ADVANCED ENERGY (SALIENT) AEX GENERATOR; ELECTROSURGICAL, CUTTING & COAGULATION & ACCES

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MEDTRONIC ADVANCED ENERGY (SALIENT) AEX GENERATOR; ELECTROSURGICAL, CUTTING & COAGULATION & ACCES Back to Search Results
Model Number 40-405-1
Medical Device Problem Code Failure to Shut Off (2939)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/13/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(h3, h6): no parts have been received by the manufacturer for evaluation.Codes b17, c20 & d15 are applicable.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.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
Information was received from a healthcare provider regarding a generator.It was reported that during pm testing of the generator, an unexpected result occurred in which the grounding indicator was red when testing with an esa and decade box.Troubleshooting included setting the decade box to 0 and adjusting the esa between the settings in the manual, but the grounding indicator remained red.No patient was involved.
 
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Brand Name
AEX GENERATOR
Common Device Name
ELECTROSURGICAL, CUTTING & COAGULATION & ACCES
Manufacturer (Section D)
MEDTRONIC ADVANCED ENERGY (SALIENT)
180 international drive
portsmouth NH 03801
Manufacturer (Section G)
MEDTRONIC ADVANCED ENERGY (SALIENT)
180 international drive
portsmouth NH 03801
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key23744158
Report Number1226420-2025-00051
Device Sequence Number21419942
Product Code GEI
UDI-Device Identifier00643169531048
UDI-Public(01)00643169531048(11)160812
Combination Product (Y/N)N
Initial Reporter StateNJ
Initial Reporter CountryUS
PMA/510(K) Number
K143175
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) 12/08/2025
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 Number40-405-1
Device Catalogue Number40-405-1
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 11/13/2025
Initial Report FDA Received Date12/08/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured08/12/2016
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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