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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC PUERTO RICO VILLALBA SENSIGHT; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINS

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MEDTRONIC PUERTO RICO VILLALBA SENSIGHT; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINS Back to Search Results
Model Number B3300542
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 a stage one procedure, intraoperative lead testing showed abnormal results with the contacts displaying all red.The lead was tested multiple times and continued to show all red- high impedances - on the contacts after reinsertion into the brain.A second lead was then tested and showed the same all red results, and a second testing cable was also tried with the same findings.The lead was removed and placed in sterile saline on the sterile table, where testing showed all green - normal impedances- and the cannula was pulled up 24 mm in the brain to ensure it was not near the electrodes.During continued testing, the contacts reportedly began to show ¿green.¿ no patient complications have been reported as a result of this event.During follow up for additional information, the manufacturer representative (rep) reiterated that troubleshooting included moving the cannula, swapping out the lead and test cable, testing the lead the second lead in a saline bath.They reconfirmed that after running the impedance check a couple times, the second lead received normal impendence's.
 
Additional Manufacturer Narrative
Continuation of d10: product id: b3300542 serial# (b)(6) i product type lead 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
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, ELECTRICAL, IMPLANTED, FOR PARKINS
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 Key24898816
Report Number2649622-2026-10876
Device Sequence Number15668292
Product Code MHY
UDI-Device Identifier00763000426392
UDI-Public(01)00763000426392(17)280223
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
P960009
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup,Followup,Followup
Report Date (Section B) 06/11/2026
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 NumberB3300542
Device Catalogue NumberB3300542
Was Device Available for Evaluation? Device Returned to Manufacturer
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/06/2026
Supplement Date Received by Manufacturer05/14/2026
05/20/2026
05/20/2026
Initial Report FDA Received Date04/16/2026
Supplement Report FDA Received Date05/15/2026
06/12/2026
06/12/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/23/2026
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...."
Patient Age58 YR
Patient SexMale
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