MAUDE Adverse Event Report: Houston Pulse Gen Model 1000; Generator

Model Number	1000
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes	Nausea (1970); Vomiting (2144); Discomfort (2330); Unspecified Gastrointestinal Problem (4491); Appropriate Clinical Signs, Symptoms and Conditions Term/Code Not Available (4581)
Date of Event	09/05/2026
Type of Reportable Event	Serious Injury
Event or Problem Description
A few days after undergoing a generator replacement the patient started experiencing nausea and upset stomach.It was further explained that the patient had difficulty keeping food and water down, nausea and vomiting and they were instructed to tape their magnet over the generator but the nausea and vomiting continued.The patient was seen at the hospital where their device was disabled but the nausea, discomfort and stomach issues persisted so the vns device was ruled out as a cause.But given the closeness to the patient feeling ill and them undergoing a generator replacement, it is still unclear is the events are related to the replacement surgery.The device history records for the generator were reviewed.The generator was confirmed to have been hp sterilized prior to distribution into the field.The device passed all specifications, including quality control inspection, and showed no non-conformities, prior to its release into the field for distribution.No other relevant information has been received to date.

• Brand Name: Pulse Gen Model 1000
• Common Device Name: Generator
• Manufacturer (Section D): Houston; 100 cyberonics boulevard; houston TX 77058
• Manufacturer (Section G): Houston; 100 cyberonics boulevard; houston TX 77058
• Manufacturer Contact: cindy scott ; 100 cyberonics blvd; suite 600; houston, TX 77058 ; +1(281)667-2681
• MDR Report Key: 50868840
• Report Number: 1644487-2026-11123
• Device Sequence Number: 9314571
• Product Code: LYJ
• UDI-Device Identifier: 05425025750405
• UDI-Public: 05425025750405
• Combination Product (Y/N): N
• Initial Reporter Country: US
• PMA/510(K) Number: P970003
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2026
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• Report Date (Section B): 09/23/2026

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?: No
• Operator of Device: Lay User/Patient
• Device Model Number: 1000
• Device Lot Number: 206783
• 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: 09/08/2026
• Initial Report FDA Received Date: 09/23/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 06/03/2026
• 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 Number: 1
• Outcome Attributed to Adverse Event: Hospitalization; Other
• Patient Age: 52 YR
• Patient Sex: Female