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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 Code Incorrect, Inadequate or Imprecise Result or Readings (1535)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/09/2026
Type of Reportable Event Malfunction
Event or Problem Description
Medtronic received information regarding an imaging system being used for a sacroiliac and thoracolumbar procedure.It was reported that during scout images, all spinous process were in-line and were centered midline.They took a scan of patient anatomy for the long scan and noted that the scan had seem to shift to the left by 5-10 cm.No patient movement, aspirations were held.This was occurred intra operatively.There was a reported delay of less than 1 hour and no reported impact to patient outcome.
 
Additional Manufacturer Narrative
(h3, h6): no parts have been received by manufacturer for evaluation.Continuation of d10: section d information references the main component of the system.Other relevant device(s) are: product id: m021083c001, serial/lot #: (b)(6).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
Additional information was received stating that it was determined that the reported issue was a clinical workflow/user error issue.
 
Additional Manufacturer Narrative
H3) additional information was added to section a, patient age and birth date.Section b5, event description.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.
 
Additional Manufacturer Narrative
H6: a software analysis was initiated.However, not a software issue.Complaint data analysis found the event is due to a user workflow issue software functioning as designed.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 Key24331918
Report Number3004785967-2026-00097
Device Sequence Number18589553
Product Code OWB
UDI-Device Identifier00763000132378
UDI-Public(01)00763000132378(11)191205
Combination Product (Y/N)N
Initial Reporter StateSC
Initial Reporter CountryUS
PMA/510(K) Number
K200074
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 05/05/2026
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 02/09/2026
Supplement Date Received by Manufacturer03/19/2026
04/16/2026
Initial Report FDA Received Date02/13/2026
Supplement Report FDA Received Date03/30/2026
05/05/2026
Date Device Manufactured12/05/2019
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 Age70 YR
Patient SexMale
Patient Weight91 KG
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