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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC, INC. PATIENT CONNECTOR; PACEMAKER/ICD/CRT NON-IMPLANTED COMPONENTS

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MEDTRONIC, INC. PATIENT CONNECTOR; PACEMAKER/ICD/CRT NON-IMPLANTED COMPONENTS Back to Search Results
Model Number 24967
Medical Device Problem Codes Communication or Transmission Problem (2896); Computer Operating System Problem (2898)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/24/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
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 the patient connector was unable to pair to the mobile programmer application in order to take a patient out of magnetic resonance imaging (mri) mode.It was noted that that the screen was frozen and it was not possible to to force close the application.Troubleshooting steps were taken to include attempting to select a different patient connector; however, the patient connector did not populate on the selection screen.There was no patient involvement.
 
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Brand Name
PATIENT CONNECTOR
Common Device Name
PACEMAKER/ICD/CRT NON-IMPLANTED COMPONENTS
Manufacturer (Section D)
MEDTRONIC, INC.
8200 coral sea street ne
mounds view MN 55112
Manufacturer (Section G)
MEDTRONIC, INC.
8200 coral sea street ne
mounds view MN 55112
Manufacturer Contact
gerard torenvliet
8200 coral sea st ne
mounds view, MN 55112-4391
7635269277
MDR Report Key23989953
Report Number2182208-2026-00108
Device Sequence Number18775623
Product Code OSR
UDI-Device Identifier00763000688479
UDI-Public(01)00763000688479(11)250523(20)01
Combination Product (Y/N)N
Initial Reporter StateAR
Initial Reporter CountryUS
PMA/510(K) Number
P890003
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) 01/07/2026
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 Number24967
Device Catalogue Number24967
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 12/24/2025
Initial Report FDA Received Date01/07/2026
Date Device Manufactured05/23/2025
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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