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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC XOMED INC. NIM-NEURO® 3.0 MAINFRAME; STIMULATOR, NERVE

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MEDTRONIC XOMED INC. NIM-NEURO® 3.0 MAINFRAME; STIMULATOR, NERVE Back to Search Results
Model Number 8253402
Medical Device Problem Code Inappropriate Audible Prompt/Feedback (2280)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/08/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3: analysis of the device did not find any fault with the device.Continuation of d10: section d information references the main component of the system.Other relevant device(s) are: product id: 8253410, serial/lot #: (b)(6), udi#: (b)(4) applicable code for pli-20 (8253410) - fdd a090101, fdm b01, fdr c19, fdc d1102, ime e2403 & img g02005.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
It was reported that pre-op, the device had a lot of interference.There was no patient involved.
 
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Brand Name
NIM-NEURO® 3.0 MAINFRAME
Common Device Name
STIMULATOR, NERVE
Manufacturer (Section D)
MEDTRONIC XOMED INC.
6743 southpoint dr n
jacksonville FL 32216
Manufacturer (Section G)
MEDTRONIC XOMED INC.
6743 southpoint dr n
jacksonville FL 32216
Manufacturer Contact
justin ellis
6743 southpoint drive north
jacksonville, FL 32216
7635265677
MDR Report Key23920290
Report Number1045254-2025-02859
Device Sequence Number13014877
Product Code ETN
UDI-Device Identifier00643169547087
UDI-Public(01)00643169547087(11)210415
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K083124
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 12/30/2025
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 Number8253402
Device Catalogue Number8253402
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/10/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/10/2025
Initial Report FDA Received Date12/30/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/15/2021
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 Unknown
Patient Sequence Number1
Patient SexUnknown
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