| Brand Name | External Neurostimulator |
| Common Device Name | STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR |
| Manufacturer (Section D) |
| Medtronic, Inc. |
| 8200 coral sea street ne |
| mounds view MN 55112 |
|
| Manufacturer (Section G) |
| Medtronic, Inc. |
| 8200 coral sea street ne |
|
| mounds view MN 55112 |
|
| Manufacturer Contact |
|
justin
ellis
|
| 8200 coral sea street ne mvs21 |
| mounds view, MN 55112
|
|
+1(763)526-5677
|
|
| MDR Report Key | 50744410 |
| Report Number | 2182208-2026-51808 |
| Device Sequence Number | 8541908 |
| Product Code |
LGW
|
| UDI-Device Identifier | 00763000586850 |
| UDI-Public | (01)00763000586850(17)271023 |
| Combination Product (Y/N) | N |
| Initial Reporter State | MN |
| Initial Reporter Country | US |
| PMA/510(K) Number | P840001 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Consumer,Health Professional,Company Representative |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
09/30/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
Yes
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Health Professional
|
| Device Model Number | 9772501 |
| Device Catalogue Number | 9772501 |
| 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 | 09/09/2026 |
| Supplement Date Received by Manufacturer | 09/11/2026
|
| Initial Report FDA Received Date | 09/11/2026 |
| Supplement Report FDA Received Date | 09/30/2026
|
| Date Device Manufactured | 04/30/2026 |
| 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
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Sex | Unknown |
|
|