O-ARM O2 IMAGING SYSTEM
Report
- Report Number
- 3004785967-2025-00525
- Event Type
- Malfunction
- Date Received
- July 30, 2025
- Date of Event
- July 8, 2025
- Report Date
- July 30, 2025
- Manufacturer
- MEDTRONIC NAVIGATION, INC. (BOXBOROUGH)
- Product Code
- OWB
- UDI-DI
- 00643169639683
- PMA / PMN Number
- K200074
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AZ, US
- Reporter Occupation
- BIOMEDICAL ENGINEER
- Health Professional
- Yes
Narratives
(H3, H6) MEDTRONIC REPRESENTATIVE WENT TO THE SITE TO TEST THE IMAGING SYSTEM AND REPLACED DOOR WINCH. PERFORMED MULTIPLE DOOR OPEN / CLOSE FUNCTIONS WITHOUT ANY ISSUES. PERFORMED SYSTEM CHECKOUT. SYSTEM WAS OPERATIONAL. B01, C07, D02, G04035, G04018 ARE APPLICABLE CONTINUATION OF D10: SECTION D INFORMATION REFERENCES THE MAIN COMPONENT OF THE SYSTEM. OTHER RELEVANT DEVICE(S) ARE: PRODUCT ID: B I71000429, PRODUCT ID: BI71000273. 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.
MEDTRONIC RECEIVED INFORMATION REGARDING AN IMAGING SYSTEM BEING USED OUTSIDE OF A PROCEDURE. IT WAS REPORTED THAT THE COVERS ARE HAVING TROUBLE OPENING AND CLOSING AS UNABLE TO OPEN/CLOSE. NO PATIENT WAS PRESENT AT THE TIME OF EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 496045 | O-ARM O2 IMAGING SYSTEM | INTERVENTIONAL FLUOROSCOPIC X-RAY SYSTEM | OWB | MEDTRONIC NAVIGATION, INC. (BOXBOROUGH) | BI70002000 | 00643169639683 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |