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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC STEALTHSTATION® S7´; INSTRUMENT, STEREOTAXIC

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MEDTRONIC NAVIGATION, INC STEALTHSTATION® S7´; INSTRUMENT, STEREOTAXIC Back to Search Results
Model Number 9733857
Medical Device Problem Code Human-Device Interface Problem (2949)
Health Effect - Clinical Code No Patient Involvement (2645)
Date of Event 09/21/2017
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Other relevant device(s) are: product id: 9731203.The system was serviced at the site and found to be fully functional.The system passed checkout and was returned to service.If information is provided in the future, a supplemental report will be issued.
 
Event or Problem Description
Medtronic received information regarding a navigation system while outside of procedure.It was reported that the navigation system was not recognizing the emitter.There was no patient present when the issue occurred.
 
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Brand Name
STEALTHSTATION® S7´
Common Device Name
INSTRUMENT, STEREOTAXIC
Manufacturer (Section D)
MEDTRONIC NAVIGATION, INC
826 coal creek circle
louisville CO 80027
MDR Report Key8717446
Report Number1723170-2019-03655
Device Sequence Number16762308
Product Code HAW
UDI-Device Identifier00613994450951
UDI-Public00613994450951
Combination Product (Y/N)N
Initial Reporter StateWV
Initial Reporter CountryUS
PMA/510(K) Number
K050438
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source user facility
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 06/20/2019
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 Number9733857
Device Catalogue Number9733857
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/21/2017
Initial Report FDA Received Date06/20/2019
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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