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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 PARKINSONIAN TREMOR

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MEDTRONIC PUERTO RICO VILLALBA SENSIGHT; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR Back to Search Results
Model Number B3300542
Medical Device Problem Codes Difficult to Insert (1316); Positioning Problem (3009)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/15/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Continuation of d10: product id neu_stylet_acc.Serial# unknown: product type accessory 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 patient was having electrode implanted for parkinson's disease.Prior to insertion, hcp observed that the guide wire was not seated inside the electrode properly.His observation is that the guide wire inthis particular electrode was not cut to specifications and is perhaps longer than the manufactured specifications.He deemed this a possible quality issue and did not feel comfortable implanting the electrode.He asked for another electrode and was satisfied with how the guide wire was seated in the electrode and the 2nd electrode was implanted in the patient.Issue is reiterated, rep said the lead stylet would not sit flush, when the surgeon pushed it in, it would pop out again.Surgeon thinks the stylet might be too long or there might be an obstruction in the lead lumen.Rep to send lead back for analysis.Out-of-box issue.
 
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Brand Name
SENSIGHT
Common Device Name
STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR
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 Key25348071
Report Number2649622-2026-16036
Device Sequence Number10326429
Product Code MHY
UDI-Device Identifier00763000426392
UDI-Public(01)00763000426392(17)280211
Combination Product (Y/N)N
Initial Reporter StateOH
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 Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,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
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/15/2026
Supplement Date Received by Manufacturer06/10/2026
Initial Report FDA Received Date06/01/2026
Supplement Report FDA Received Date06/11/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/11/2026
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 Age64 YR
Patient SexMale
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