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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC PUERTO RICO VILLALBA SENSIGHT; Stimulator, thalamic, epilepsy, implanted

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MEDTRONIC PUERTO RICO VILLALBA SENSIGHT; Stimulator, thalamic, epilepsy, implanted Back to Search Results
Model Number B3300542M
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Unspecified Infection (1930)
Date of Event 01/06/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that patient visited with neurosurgeon; it was decided that patient had active infection and equipment needed to be explanted.Patient went in for surgery on 1/6/26 to explant both leads.Patient is alive with no additional injury; outcome of the infection is unknown at this.Additional information received from rep indicating that hcp will wait 3-6 months for infection to clear before considering reimplanting.It is not known if the infection is yet resolved.No other manufacturer devices were involved in the explantation.Devices were discarded after surgery.
 
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.
 
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Brand Name
SENSIGHT
Common Device Name
Stimulator, thalamic, epilepsy, implanted
Manufacturer (Section D)
MEDTRONIC PUERTO RICO VILLALBA
road 149 km 56.3
villalba PR 00766
Manufacturer (Section G)
MEDTRONIC PUERTO RICO VILLALBA
road 149 km 56.3
villalba PR 00766
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key24133378
Report Number2649622-2026-01903
Device Sequence Number13358999
Product Code MBX
UDI-Device Identifier00763000426408
UDI-Public(01)00763000426408(17)261118
Combination Product (Y/N)N
Initial Reporter StateNY
Initial Reporter CountryUS
PMA/510(K) Number
P960009
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 01/21/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Operator of Device Health Professional
Device Model NumberB3300542M
Device Catalogue NumberB3300542M
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 01/07/2026
Initial Report FDA Received Date01/21/2026
Date Device Manufactured11/18/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
"SEE H11...."
Outcome Attributed to Adverse Event Required Intervention;
Patient Age38 YR
Patient SexMale
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