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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Medtronic Xomed Inc. NIM 4.0 CONSOLE; STIMULATOR, ELECTRICAL, EVOKED RESPONSE

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Medtronic Xomed Inc. NIM 4.0 CONSOLE; STIMULATOR, ELECTRICAL, EVOKED RESPONSE Back to Search Results
Model Number NIM4CM01
Medical Device Problem Codes False Negative Result (1225); Incorrect, Inadequate or Imprecise Result or Readings (1535)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/18/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that intra-op, error code was received after the start, the console had an alarm problem 'out of the measurement range' messages during surgery, which were resolved by checking the electrodes.The second more important problem, when approaching the nerve, the beeping sound was present but no feedback on the curve on the screen during the intervention despite the verification of consumables and connections, there was no fault with the other components.There was no patient impact.
 
Additional Manufacturer Narrative
H6: the codes fdm b16, fdr c20, fdc d16 and img g02030 are applicable for nim console (nim4cm01).Continuation of d10: section d information references the main component of the system.Other relevant device(s) are: product id: nim4cpb1, serial/lot #: p2214239, ubd: , udi#: 00763000395902 h6: the codes fdm b16, fdr c20, fdc d16 and img g02005 are applicable for nim patient interface(nim4cpb1).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
NIM 4.0 CONSOLE
Common Device Name
STIMULATOR, ELECTRICAL, EVOKED RESPONSE
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 Key50706762
Report Number1045254-2026-01257
Device Sequence Number10696422
Product Code GWF
UDI-Device Identifier00763000395896
UDI-Public(01)00763000395896(11)221220
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K200759
Number of Events Summarized1
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) 09/10/2026
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 NumberNIM4CM01
Device Catalogue NumberNIM4CM01
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/18/2026
Initial Report FDA Received Date09/10/2026
Date Device Manufactured12/20/2022
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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