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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC PUERTO RICO OPERATIONS CO. Percept; IMPLANTED SUBCORTICAL ELECTRICAL STIMULATOR (M

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MEDTRONIC PUERTO RICO OPERATIONS CO. Percept; IMPLANTED SUBCORTICAL ELECTRICAL STIMULATOR (M Back to Search Results
Model Number B35300
Medical Device Problem Code High impedance (1291)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/18/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that bilateral elevated impedance occurred during implantable neurostimulator (ins) to lead connection on contacts 3 and 11.Patient was asleep during procedure and no further intervention planned at this time. connection at head was opened, clean and dried bilaterally with no change in impedance.Connection at ins was opened cleaned and dried with no change in impedance.This process was repeated with no change.New extension was opened and tested on both sides outside of the body with no change in impedance.
 
Additional Manufacturer Narrative
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
Percept
Common Device Name
IMPLANTED SUBCORTICAL ELECTRICAL STIMULATOR (M
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 Key50869855
Report Number3004209178-2026-16135
Device Sequence Number13117989
Product Code MRU
UDI-Device Identifier00763000564346
Combination Product (Y/N)N
Initial Reporter StateDC
Initial Reporter CountryUS
PMA/510(K) Number
H020007
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
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? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model NumberB35300
Device Catalogue NumberB35300
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 09/18/2026
Initial Report FDA Received Date09/23/2026
Date Device Manufactured07/10/2026
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 Number1
Patient Age15 YR
Patient SexMale
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