| Brand Name | Percept |
| Common Device Name | STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINS |
| Manufacturer (Section D) |
| MEDTRONIC PUERTO RICO OPERATIONS CO. |
| road 31, km. 24, hm 4 |
| ceiba norte industrial park |
| juncos PR 00777 |
|
| Manufacturer (Section G) |
| MEDTRONIC PUERTO RICO OPERATIONS CO. |
| road 31, km. 24, hm 4 |
| ceiba norte industrial park |
| juncos PR 00777 |
|
| Manufacturer Contact |
|
justin
ellis
|
| 8200 coral sea street ne mvs21 |
| mounds view, MN 55112
|
|
+1(763)526-5677
|
|
| MDR Report Key | 50291523 |
| Report Number | 3004209178-2026-13836 |
| Device Sequence Number | 13185181 |
| Product Code |
MHY
|
| UDI-Device Identifier | 00763000642174 |
| UDI-Public | (01)00763000642174(17)260414 |
| Combination Product (Y/N) | N |
| Initial Reporter State | MN |
| Initial Reporter Country | US |
| PMA/510(K) Number | P960009 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2024 |
| 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 |
| Report Date (Section B) |
09/16/2026 |
| 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 Expiration Date | 04/14/2026 |
| Device Model Number | B35200 |
| Device Catalogue Number | B35200 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/11/2026 |
| Supplement Date Received by Manufacturer | 09/03/2026
|
| Initial Report FDA Received Date | 08/18/2026 |
| Supplement Report FDA Received Date | 09/17/2026
|
| Date Device Manufactured | 04/15/2024 |
| 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 Number | 1 |
| Patient Age | 70 YR |
| Patient Sex | Male |
|
|