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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC. PLASMABLADE X PS210-030S-LIGHT 3.0SL; ELECTROSURGICAL, CUTTING & COAGULATION & ACCES

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MEDTRONIC NAVIGATION, INC. PLASMABLADE X PS210-030S-LIGHT 3.0SL; ELECTROSURGICAL, CUTTING & COAGULATION & ACCES Back to Search Results
Model Number PS210-030S-LIGHT
Medical Device Problem Code Electromagnetic Interference (1194)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/23/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3: device not returned to medtronic for evaluation.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
Information was received from a healthcare provider regarding a handpiece.It was reported that when cut or coag on the handle of the handpiece was pressed, other device magnetic breaks would lock or unlock.A patient was involved but there was no known impact on the patient outcome.There was no delay to the procedure.
 
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Brand Name
PLASMABLADE X PS210-030S-LIGHT 3.0SL
Common Device Name
ELECTROSURGICAL, CUTTING & COAGULATION & ACCES
Manufacturer (Section D)
MEDTRONIC NAVIGATION, INC.
200 medtronic drive
lafayette,co
Manufacturer (Section G)
MEDTRONIC NAVIGATION, INC.
200 medtronic drive
lafayette,co
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key25214595
Report Number1723170-2026-00766
Device Sequence Number21518817
Product Code GEI
UDI-Device Identifier00763000279165
UDI-Public(01)00763000279165(17)281031(10)2411013(20)01
Combination Product (Y/N)N
Initial Reporter StateMI
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other
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 NumberPS210-030S-LIGHT
Device Catalogue NumberPS210-030S-LIGHT
Device Lot Number2411013
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/23/2026
Initial Report FDA Received Date05/19/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/01/2025
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
Patient Sequence Number1
Patient Age82 YR
Patient SexMale
Patient Weight83 KG
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