| Brand Name | NIM® 3.0 INTERFACE |
| Common Device Name | STIMULATOR, NERVE |
| Manufacturer (Section D) |
| Medtronic Xomed Inc. |
| 6743 southpoint dr n |
| jacksonville FL 32216 |
|
| Manufacturer (Section G) |
| Medtronic Xomed Inc. |
| 6743 southpoint dr n |
|
| jacksonville FL 32216 |
|
| Manufacturer Contact |
|
justin
ellis
|
| 6743 southpoint drive north |
| jacksonville, FL 32216
|
|
+1(763)526-5677
|
|
| MDR Report Key | 50126506 |
| Report Number | 1045254-2026-01084 |
| Device Sequence Number | 12162148 |
| Product Code |
ETN
|
| UDI-Device Identifier | 00643169782440 |
| UDI-Public | (01)00643169782440(11)181205 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | CH |
| PMA/510(K) Number | K083124 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
08/04/2026 |
| 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 Number | 8253200 |
| Device Catalogue Number | 8253200 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 07/28/2026 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 07/28/2026 |
| Initial Report FDA Received Date | 08/04/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 12/05/2018 |
| 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 Number | 1 |
| Patient Sex | Unknown |