BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MICRA

    MDR report key: 23035421 · Received September 12, 2025

    Report

    Report Number
    2182208-2025-04575
    Event Type
    Injury
    Date Received
    September 12, 2025
    Date of Event
    August 18, 2025
    Report Date
    September 15, 2025
    Manufacturer
    MEDTRONIC, INC.
    Product Code
    DYB
    UDI-DI
    00763000770730
    PMA / PMN Number
    K132030
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    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.

    Additional Manufacturer Narrative · 0

    CORRECTED: B5, H2, ADDITIONAL CODES 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.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT DURING THE IMPLANT PROCEDURE OF THE LEADLESS IMPLANTABLE PULSE GENERATOR (IPG) DELIVERY SYSTEM (DS) BEFORE PLACEMENT NEGATIVE PRESSURE WAS APPLIED VIA A SYRINGE THROUGH THE FLUSH PORT OF THE INTRODUCER HOWEVER THE SYRINGE COULD NOT BE PULLED BACK, PREVENTING AIR REMOVAL. WHEN THE DEFLECTION BUTTON WAS PRESSED ON THE LEADLESS IMPLANTABLE PULSE GENERATOR (IPG) (DS) NO RESPONSE WAS OBSERVED AND THE LEADLESS IPG WAS PROTRUDING. THE LEADLESS IPG DS AND INTRODUCER WERE ATTEMPTED NOT USED AND REPLACED. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

    Description of Event or Problem · 0

    IT WAS FURTHER REPORTED THAT THE PATIENT EXPERIENCED INTERMITTENT CARDIAC ARREST DURING THE IMPLANT PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2330546 MICRA INTRODUCER, CATHETER DYB MEDTRONIC, INC. MI2355A P2F25D0016 00763000770730

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Unknown Life Threatening