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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC PUERTO RICO OPERATIONS CO. Inceptiv; STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR

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MEDTRONIC PUERTO RICO OPERATIONS CO. Inceptiv; STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR Back to Search Results
Model Number 977119
Medical Device Problem Codes Battery Problem (2885); Charging Problem (2892)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/09/2026
Type of Reportable Event Malfunction
Event or Problem Description
Information was received from a patient (pt) regarding an implantable neurostimulator (ins).The pt reported that the newly implanted ins battery was not working well.They stated that the ins had been implanted in november and that they had needed to charge it frequently.Pt reported first noticing the issue about 3 months after implantation.They stated that the battery did not last more than 12 hours.Pt mentioned using scs to avoid taking analgesic medication and expressed dissatisfaction with the device's battery performance.Agent reviewed ins battery duration.The pt was redirected to their healthcare provider (hcp) to further address the issue.Pt mentioned that they had contacted their hcp but had not yet received a response.
 
Additional Manufacturer Narrative
B3: date is approximate.Year is confirmed valid.B3: event date is not known.Please see b5 for approximate date range, if applicable.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
Inceptiv
Common Device Name
STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR
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 Key50933874
Report Number3004209178-2026-16518
Device Sequence Number15852454
Product Code LGW
UDI-Device Identifier00763000984687
Combination Product (Y/N)N
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
P840001
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Type of Report Initial
Report Date (Section B) 09/29/2026
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 Number977119
Device Catalogue Number977119
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 09/25/2026
Initial Report FDA Received Date09/29/2026
Date Device Manufactured10/29/2025
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 Age65 YR
Patient SexFemale
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