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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC PUERTO RICO OPERATIONS CO. PERCEPT; IMPLANTED SUBCORTICAL ELECTRICAL STIMULATOR (M

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MEDTRONIC PUERTO RICO OPERATIONS CO. PERCEPT; IMPLANTED SUBCORTICAL ELECTRICAL STIMULATOR (M Back to Search Results
Model Number B35200
Medical Device Problem Code High impedance (1291)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/06/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during elective replacement of the implantable neurostimulator (ins), elevated impedances were identified on the right side contacts 1, 2, and 3.Impedance testing was performed at the highest voltage.Impedances remained elevated with the new generator.No patient injury was reported.
 
Additional Manufacturer Narrative
Continuation of d10: product id b35200 (b)(6); product type: 0197-implantable neurostimulator; implant date (b)(6) 2026; explant date section d references the main component of the system.Other medical products in use during the event include: brand name activa; product id 3389s-40 (serial: unknown); product type: 0200-lead; implant date; explant date 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
PERCEPT
Common Device Name
IMPLANTED SUBCORTICAL ELECTRICAL STIMULATOR (M
Manufacturer (Section D)
MEDTRONIC PUERTO RICO OPERATIONS CO.
road 31, km. 24, hm 4
ceiba norte industrial park
juncos PR 00777
Manufacturer (Section G)
MEDTRONIC PUERTO RICO OPERATIONS CO.
road 31, km. 24, hm 4
ceiba norte industrial park
juncos PR 00777
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key24816390
Report Number3004209178-2026-06103
Device Sequence Number5952730
Product Code MRU
UDI-Device Identifier00763000420987
UDI-Public(01)00763000420987(17)221128
Combination Product (Y/N)N
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
H020007
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2021
Device Explanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 04/08/2026
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 Expiration Date11/28/2022
Device Model NumberB35200
Device Catalogue NumberB35200
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/06/2026
Initial Report FDA Received Date04/08/2026
Date Device Manufactured12/08/2020
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
Patient Age15 YR
Patient SexMale
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