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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC. (BOXBOROUGH) O-ARM O2 IMAGING SYSTEM; INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM

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MEDTRONIC NAVIGATION, INC. (BOXBOROUGH) O-ARM O2 IMAGING SYSTEM; INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM Back to Search Results
Model Number BI70002000
Medical Device Problem Codes Failure to Advance (2524); Device Sensing Problem (2917); Noise, Audible (3273); Application Program Freezes or Fails to Launch (4031)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/09/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(h3, h6) medtronic representative went to the site to test the imaging system and inspections confirms that the door was functioning as intended upon arrival.Dingus was in the correct position.Trained cc¿s on door opening / closing with ratchet.Door odometer was at approx 2000.Shaved door split skin covers as this seems to be the issue with the popping noise.System checkout passed.System is fully functional.Staff notified.B01, c07, d02, g07001 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.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 an imaging system being used outside of a procedure.It was reported that the system was having difficulty opening and closing.Whenever representative pressed the open or close buttons on the pendant, the gantry did not move.As a result, performed a manual opening of the system using the rachet.Once the gantry had been manually opened, the open/close buttons on the pendant worked again.Representative closed the gantry all the way using the pendant button.However, a loud popping noise was heard right as the gantry fully closed.Despite being fully closed, the pendant still displayed a "door open" message.No patient was present at the time of event.
 
Additional Manufacturer Narrative
H2) continuation of d10: section d information references the main component of the system.Other relevant device(s) are: product id: bi71000202, serial/lot #: unknown.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
O-ARM O2 IMAGING SYSTEM
Common Device Name
INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM
Manufacturer (Section D)
MEDTRONIC NAVIGATION, INC. (BOXBOROUGH)
200 beaver brook rd
boxborough,ma 45640
MX  45640
Manufacturer (Section G)
MEDTRONIC NAVIGATION, INC. (BOXBOROUGH)
200 beaver brook rd
boxborough,ma 45640
MX   45640
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key23847173
Report Number3004785967-2025-00816
Device Sequence Number13143387
Product Code OWB
UDI-Device Identifier00763000132378
UDI-Public(01)00763000132378(11)181108
Combination Product (Y/N)N
Initial Reporter StateTN
Initial Reporter CountryUS
PMA/510(K) Number
K200074
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,Followup
Report Date (Section B) 01/05/2026
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 NumberBI70002000
Device Catalogue NumberBI70002000
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/09/2025
Supplement Date Received by Manufacturer12/19/2025
Initial Report FDA Received Date12/19/2025
Supplement Report FDA Received Date01/05/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/08/2018
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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