ACTIVA 37612

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,consum report with the FDA on 2020-03-30 for ACTIVA 37612 manufactured by Medtronic Puerto Rico Operations Co..

Event Text Entries

[185543580] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[185543581] It was reported that the patient is concerned because their rechargeable implantable neurostimulator (ins) has shown that it has been at 100% for 36 hours. The patient clarified that their ins battery is not depleting and they cannot charge their ins due to this. They mentioned their ins was located in their belly. There are no return of symptoms reported. The manufacturer representative (rep) walked the patient through using the patient programmer (pp) and the pp batteries showed 50% and the ins showed 100%. They stated that the patient mentioned that the pp screen was flashing off and then said it was on. Thus, it is unknown whether the therapy had been off or not and for how long. The patient's recharger, when attempting to charge showed 100% and no bars. Technical services reviewed that since the therapy is confirmed on now, to wait and see if the battery depletes, if not, for the rep to call back. The patient called and confirmed on the call that stimulation was on and their pp was showing 100%. They stated they were able to successfully charge their ins briefly and then described seeing either the charge sufficient or charge complete screen on their implantable neurostimulator recharger (insr), but could not clarify which screen they were seeing. The patient stated that stimulation may have been turned off before. Patient services recommended the patient to monitor their ins battery level now that it is confirmed stimulation is on and call back if the issue persists.
Patient Sequence No: 1, Text Type: D, B5


[186460447] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[186460448] Additional information was received that the patient believes the reason it was not depleting was due to their having accidentally turning their device off. They stated they believed they turned it off while checking the charge with their patient programmer (pp). This resulted in the battery not depleting. The patient turned their device back on and was allowing "a couple of days" to go by before charging. They stated the issue was resolved.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004209178-2020-06374
MDR Report Key9897860
Report SourceCOMPANY REPRESENTATIVE,CONSUM
Date Received2020-03-30
Date of Report2020-04-01
Date of Event2020-03-26
Date Mfgr Received2020-03-30
Device Manufacturer Date2019-08-16
Date Added to Maude2020-03-30
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactLISA WOODWARD CLARK
Manufacturer Street7000 CENTRAL AVENUE NE RCW215
Manufacturer CityMINNEAPOLIS MN 55432
Manufacturer CountryUS
Manufacturer Postal55432
Manufacturer Phone7635263920
Manufacturer G1MEDTRONIC PUERTO RICO OPERATIONS CO.
Manufacturer StreetROAD 31, KM. 24, HM 4 CEIBA NORTE INDUSTRIAL PARK
Manufacturer CityJUNCOS PR 00777
Manufacturer CountryUS
Manufacturer Postal Code00777
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameACTIVA
Generic NameSTIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR
Product CodeMHY
Date Received2020-03-30
Model Number37612
Catalog Number37612
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC PUERTO RICO OPERATIONS CO.
Manufacturer AddressROAD 31, KM. 24, HM 4 CEIBA NORTE INDUSTRIAL PARK JUNCOS PR 00777 US 00777


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-30

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