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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC, INC. DUAL CHAMBER TEMPORARY PACEMAKER; PULSE-GENERATOR, PACEMAKER, EXTERNAL

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MEDTRONIC, INC. DUAL CHAMBER TEMPORARY PACEMAKER; PULSE-GENERATOR, PACEMAKER, EXTERNAL Back to Search Results
Model Number 5392
Medical Device Problem Code Display or Visual Feedback Problem (1184)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/19/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product analysis: analysis was able confirm the customer comment that the external pulse generator (epg) displayed an error code.It was noted that the main printed circuit board (pcb) was out of specification electrical.It was also determined at analysis that liquid crystal display (lcd) was bleeding and epg failed the incoming functional test and displayed message "all segments of lcd turned on/off".Additionally, it was noted that the upper case was dented and battery drawer was broken.The epg was decommissioned as it was no longer serviceable 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 external pulse generator (epg) displayed an error code during preventative maintenance testing.Troubleshooting steps were taken including powered down the unit to no avail.The epg has been returned for evaluation and subsequently tested out of specification during manufacturer's analysis.There was no patient involvement.
 
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Brand Name
DUAL CHAMBER TEMPORARY PACEMAKER
Common Device Name
PULSE-GENERATOR, PACEMAKER, EXTERNAL
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 Key24528418
Report Number2182208-2026-07082
Device Sequence Number8504040
Product Code DTE
UDI-Device Identifier00643169508767
UDI-Public(01)00643169508767(11)150318
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
K150246
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Biomedical Engineer
Type of Report Initial
Report Date (Section B) 03/06/2026
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 Number5392
Device Catalogue Number5392
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/25/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/26/2026
Initial Report FDA Received Date03/06/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/18/2015
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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