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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 Application Program Freezes or Fails to Launch (4031)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/22/2026
Type of Reportable Event Malfunction
Event or Problem Description
Medtronic received the information regarding an imaging system being used outside of procedure.It was reported that the system was stuck in stand alone mode.No patient present.
 
Additional Manufacturer Narrative
H3, h6) the manufacture representative went to the site to test the imaging system and system stuck in stand alone.Would not expose.Replaced the umbilical cable.System now booted, was returning to customer and was working as intended.H3, h6) the component was returned to the manufacturer for analysis.Analysis found that confirmed reported complaint."stand alone mode." imaging system, umbilical cable passed bench test.Continuity test passed and was installed in imaging system.The system did not ready.Intermittent virtual cp network cable.Continuation of d10: section d information references the main component of the system.Other relevant device(s) are: product id: bi71000167, 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.
 
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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 Key25207220
Report Number3004785967-2026-00246
Device Sequence Number8873723
Product Code OWB
UDI-Device Identifier00763000132378
UDI-Public(01)00763000132378(11)190205
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
K200074
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 05/19/2026
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
Device Lot Number-
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/04/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/11/2026
Initial Report FDA Received Date05/18/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/05/2019
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 SexUnknown
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