Explanation of symbols on product or package labeling
Refer to the appropriate product for symbols that apply.
Consult instructions for use
Use by
Sterilized using ethylene oxide
-XX °C
-XX °F
EO
Do not reuse
Do not resterilize
2
STERILIZE
Do not use if package is damaged
Manufacturer
Date of manufacture
XX °C
Temperature limitation
XXX °F
Serial number
STERILE
PIN No.
MR
PIN number
Magnetic Resonance (MR) Unsafe
IEC60601-1/EN60601-1, Type BF equipment
Keep dry
2017-06-01 English 3
For USA audiences only
Authorized Representative in the European Community
REP
EC
Conformité Européenne (European Conformity). This symbol means
that the device fully complies with MDD 93/42/EEC (NB 0123).
Do not dispose of this product in the unsorted municipal waste stream.
Dispose of this product according to local regulations. See http://
recycling.medtronic.com for instructions on proper disposal of this
product.
Chinese Standard (SJ/T11364-2006) Logo: Electronic Information
Products Pollution Control Symbol. (The "e" in this logo signifies none
of the restricted substances are present above permitted levels.)
The Technical Conformity mark signifies that this device complies with
Japan Radio Law.
The KCC Certification mark signifies that this device complies with
South Korea's radio requirements for telecommunication equipment.
The RCM Certification mark signifies that this device complies with
Australia/New Zealand EMC requirements for electrical and electronic
equipment.
4 English 2017-06-01
Medtronic® and SoftStart/Stop® are trademarks of Medtronic, Inc., registered in the U.S.
and other countries.
The BLUETOOTH
SIG, Inc., and any use of such marks by Medtronic is under license.
®
word mark and logos are registered trademarks owned by Bluetooth
2017-06-01 English 5
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Table of contents
Purpose of the device 9
Description 9
Package contents 9
Accessories 9
Device specifications 9
Declaration of Conformity 13
Instructions for use 14
Pairing the wireless external neurostimulator to a programmer or controller 14
Using the wireless external neurostimulator during intraoperative testing 14
Wireless external neurostimulator batteries 15
Changing the wireless external neurostimulator batteries 16
Connecting leads to the wireless external neurostimulator 18
Inserting 4-contact lead(s) into the wireless external neurostimulator 18
Inserting 8-contact lead(s) into the wireless external neurostimulator 20
Preparing the wireless external neurostimulator for trial stimulation 21
Removing the wireless external neurostimulator after trial stimulation 22
Device care and storage 22
Safety and technical checks 23
Refer to the indications sheet for indications and related information.
Refer to the appropriate information for prescribers booklet for contraindications,
warnings, precautions, adverse events summary, individualization of treatment,
patient selection, use in specific populations, resterilization, and component
disposal.
Refer to System Eligibility, Battery Longevity, Specifications reference manual for
neurostimulator selection, battery longevity calculations and specific
neurostimulator specifications.
! USA
Refer to the clinical summary booklet for information on the clinical study
results of the neurostimulation system and individualization of treatment.
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Purpose of the device
The Medtronic Model 97725 Wireless External Neurostimulator (ENS) is part of a
neurostimulation system used for intraoperative testing during lead placement and for trial
stimulation outside of the operating room.
Description
The Medtronic Model 97725 Wireless External Neurostimulator is a disposable, sterile,
single-use device equipped with BLUETOOTH
®
wireless technology.
Package contents
Wireless external neurostimulator with batteries inserted
▪
Spare nonsterile AAA alkaline batteries (2)
▪
Product literature
▪
! USA
Warranty card
▪
Accessories
Model 375003 External Neurostimulator Boot (nonsterile accessory kit – packaged
▪
separately)
Device specifications
The Model 97725 Wireless External Neurostimulator (Figure 1 and Figure 2) is a multiprogrammable device that delivers stimulation through one or more lead-extension(s),
depending on the system configuration. The stimulation settings are stored in programs to
target specific effects or areas. A program is a specific combination of pulse width, rate, and
intensity settings acting on a specific electrode combination (up to 16 electrodes per
program). Up to four programs can be included in a group, and there can be up to three
groups of programs. When a group contains more than one program, the pulses are
delivered sequentially—first a pulse from one program, then a pulse from the next program.
Pulse width, rate, intensity, cycling, and electrode polarity for each program within a group
can have different values. Rate limits, pulse width limits, and intensity limits for each
program within a group have the same values.
2017-06-01 English 9
ENS button
Lead door seams
Lead housing
compartment,
black (electrodes 8-15)
Lift tabs
Lead housing
compartment,
white (electrodes 0-7)
Figure 1. Model 97725 Wireless External Neurostimulator (doors closed).
LED light
8 - contact
lead groove
Electrical
contacts
4 - contact
lead groove
Retainer clip
Figure 2. Model 97725 Wireless External Neurostimulator (doors open).
Table 1. Operating values for the Model 97725 Wireless External Neurostimulator
Programmable parameter
Operating values and ranges
a
Number of defined groups1 – 3
Number of programs12
Number of programs per
group
1 – 4
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Table 1. Operating values for the Model 97725 Wireless External Neurostimulator
Programmable parameter
Operating values and ranges
(continued)
a
Electrode configuration2 – 16 electrodes as anode (+), cathode (-), or Off
Maximum intensity per
electrode
0 – 25.5 mA (0.1 mA increment)
Program intensity0 – 100 mA
Intensity – limitsEnabled or disabled at maximum 25.5 mA per electrode
Pulse width60 – 1000 µs (10-µs increment)
Pulse width – limitsEnabled or disabled at maximum 1000 µs
Rate
b
40 – 1200 Hz (increment: 5 Hz from 40 – 250 Hz, 10 Hz from
250 – 500 Hz, 20 Hz from 500 – 1000 Hz, 50 Hz from
1000 – 1200 Hz)
Rate ratioA fraction of the rate (1/1, 1/2, 1/3, 1/4, 1/5, 1/6, 1/7, 1/8, 1/9,
SoftStart/StopOff, On: 1, 2, 4, or 8 second ramp duration
CyclingOff: 0.1 s – 30 min (increment: 0.1 s from 0.1 – 1 s, 1 s from
1 s – 1 min, 1 min from 1 – 30 min)
On: 5 s – 30 min (increment: 1 s from 5 s – 1 min, 1 min from
1 – 30 min)
a
Interlocks will prevent the use of some parameter combinations.
b
Rate availability depends on how many programs are defined. For example, the maximum rate available
in one defined program is 1200 Hz. The maximum rate available if two programs are defined is 600 Hz in
each of those two programs.
Table 2. Physical characteristics of the Model 97725 Wireless External
Neurostimulator
a
DescriptionValue
Capacity
Leads4 quadripolar; 2 octapolar
Electrodes32 electrodes, supporting 16 active
Length79 mm (3.1 in)
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Table 2. Physical characteristics of the Model 97725 Wireless External
Neurostimulator
a
(continued)
DescriptionValue
Width74 mm (2.9 in)
Thickness20 mm (0.8 in)
Weight (with batteries)71 g (2.5 oz)
Battery life
External neurostimulator
service life
7 days minimum for alkaline batteries
c
90 days
b
Power sourceAAA alkaline batteries (2)
Operating typeContinuous
Degree of protection against
electrical shock
Automatic shut off
d
Type BF
Lead door(s) open
Operating temperature9 °C to 40 °C (49 °F to 104 °F)
e
Temperature limitation
-20 °C to 54 °C (-4 °F to 129 °F)
Identification codeNLJ
a
All measurements are approximate.
b
Battery life is based on a 7-day trial using two active programs, 20 90-second daily controller
BLUETOOTH sessions, and a 180-minute clinician programmer BLUETOOTH session. For program 1:
impedance = 620 Ω, Amp = 10.6 mA, PW = 330 µs, Rate = 60 Hz. For program 2: impedance = 560 Ω,
Amp = 10.5 mA, PW = 330 µs, Rate = 60 Hz.
c
Service life is based on 24-hour stimulation.
d
Use the clinician programmer or controller to turn stimulation on once the condition is resolved.
e
Store the external neurostimulator at room temperature.
Table 3. Material of components in the Model 97725 Wireless External Neurostimulator
and boot accessory packages
ComponentMaterialMaterial contacts
human tissue
Housing
BasePolycarbonateYes
Lead doorsPolycarbonateYes
Hinge pinStainless steelNo
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Table 3. Material of components in the Model 97725 Wireless External Neurostimulator
ComponentMaterialMaterial contacts
ContactsGold- and nickel-plated beryllium copperNo
Retainer clipThermoplastic elastomer (TPE)Yes
Medtronic declares that this product is in conformity with the essential requirements of
Directive 93/42/EEC on Medical Devices.
For additional information, contact the appropriate Medtronic representative listed on the
inside back cover of this manual.
2017-06-01 English 13
Instructions for use
The wireless external neurostimulator can be used for intraoperative testing during lead
placement and for trial stimulation outside of the operating room.
Warning:
reprocess, or resterilize this product. Reuse, reprocessing, or resterilization may
compromise the structural integrity of the device and/or create a risk of contamination
of the device, which could result in patient injury, illness, or death.
Warning
or who have any neurostimulation system components that are not fully implanted.
Explant all trial stimulation components if an MRI scan is required. MRI has not been
tested on trial stimulation components and may cause heating of the lead electrodes,
resulting in tissue damage or serious patient injury.
Caution:
mixture with air or with oxygen or nitrous oxide. The consequences of using the device
near flammable atmospheres are unknown.
Caution:
damage to the device, causing the device to malfunction or become unusable.
Caution:
communication. If EMI interference is suspected, move away from the likely source of
EMI and try again.
Notes:
Before placing the external neurostimulator into operation, ensure the external
▪
neurostimulator has had time to equalize to the current temperature and environment.
For more information on EMI and x-ray use with the external neurostimulator, refer to
▪
the
Turn stimulation off and dispose of the external neurostimulator after defibrillation. For
▪
more information on the effects of defibrillation on the neurostimulator, refer to the
Information for Prescribers Booklet
Pairing the wireless external neurostimulator to a programmer or
controller
For instructions on pairing the external neurostimulator to the clinician programmer or the
controller, refer to the appropriate clinician programming guide.
Using the wireless external neurostimulator during intraoperative
testing
When programming during intraoperative testing, keep the clinician programmer within 3
meters (10 feet) of the external neurostimulator. The external neurostimulator is sterile and
does not attach to the programmer. Do not use the external neurostimulator if the storage
This device was designed for single patient use only. Do not reuse,
: Physicians should not prescribe MRI for patients undergoing trial stimulation
The device is not certified for use in the presence of a flammable anesthetic
Do not modify this equipment. Modification of this equipment can result in
Electromagnetic interference (EMI) can disrupt programming and telemetry
Information for Prescribers Booklet
.
.
14 English 2017-06-01
package has been pierced or altered because component sterility cannot be guaranteed. If
external neurostimulator sterility is compromised during intraoperative testing, do not use
the external neurostimulator.
Using the ENS button
The
ENS
button is used to put the external neurostimulator into discovery mode to establish
communication with a clinician programmer or controller. It can also be used when you
need to immediately turn stimulation off. You must use either the clinician programmer or
controller to turn stimulation on.
Press and hold the
▪
Understanding the LED light on the wireless external neurostimulator
When you press and hold the
shines continuously for a few seconds. When the LED begins to flash, the external
neurostimulator has completed initiation, has entered discovery mode, and can be paired to
a clinician programmer or controller.
Notes:
The external neurostimulator will remain in discovery mode for 90 seconds, or until it
▪
successfully pairs with a clinician programmer or controller, at which point the LED
will stop flashing and turn off.
The LED flashes at a constant rate whenever the external neurostimulator is in
▪
discovery mode.
The LED will flash whenever the external neurostimulator receives data from a
▪
clinician programmer or controller.
Refer to the appropriate clinician programming guide or controller patient manual for
▪
more information.
ENS
button for at least 3 seconds to turn stimulation off.
ENS
button for one second, the light-emitting diode (LED)
Wireless external neurostimulator batteries
Two AAA alkaline batteries are preinserted in the sterile external neurostimulator and
should last the length of the trial stimulation period (see Table 2 for more information on
battery longevity). Replace the external neurostimulator batteries when the batteries are low
or depleted. The battery level is shown on the clinician programmer and controller screens.
For instructions on checking the external neurostimulator batteries, refer to the appropriate
clinician programming guide.
Patient use and stim usage data are automatically saved to the external neurostimulator at
the beginning of each hour. However, if the external neurostimulator batteries are replaced
before the data is saved, the patient use and stim usage data for the previous hour may be
lost. Prior to replacing the batteries, start a session with the clinician programmer. This
allows the clinician programmer app to retrieve the data from the external neurostimulator.
Caution:
Do not leave depleted batteries in the external neurostimulator. The
batteries may corrode and cause damage to the electronic components.
2017-06-01 English 15
Changing the wireless external neurostimulator batteries
Note:
Two spare, nonsterile AAA alkaline batteries are provided in the external
neurostimulator package. Always replace the external neurostimulator batteries
outside of the sterile field.
1.
If stimulation is on, use the clinician programmer or controller to turn stimulation off.
2.
If the batteries are being changed while the patient is undergoing trial stimulation:
a. Remove the tape from the external neurostimulator, and if applicable, the external
neurostimulator from the boot, keeping lead(s) and lead exit site secure. For
instructions on removing the external neurostimulator from the boot, refer to the
external neurostimulator boot instructions for use.
b. Lift the lift tabs to open the lead doors.
c. Note the location of each of the lead(s) in the external neurostimulator to ensure
identical seating of the lead(s) inside the lead grooves after the batteries are
changed.
d. Gently lift each lead from the electrical contacts in the lead groove.
Note:
Remove the leads from the external neurostimulator prior to replacing the
batteries in order to avoid lead kinking or dislodgement.
3.
Press back lightly on the latch of battery compartment cover, swing the cover open,
then remove the cover (Figure 3).
Figure 3. Removing battery cover.
Note:
Before replacing batteries, check for signs of battery leakage. If any residue is
present, do not use the external neurostimulator.
4.
Remove the depleted batteries, and insert new, Medtronic-supplied AAA alkaline
batteries. Correct battery polarity is indicated inside the battery compartment
(Figure 4).
Note:
For optimal performance, use the same AAA alkaline batteries as those
supplied by Medtronic.
16 English 2017-06-01
Figure 4. Inserting new batteries.
5.
Replace the battery compartment cover, then press the cover until it snaps into place
(Figure 5).
Figure 5. Replace battery cover.
Notes:
After the batteries are installed and the battery compartment cover is closed, the
▪
external neurostimulator may take up to 6 seconds for device initiation.
Stimulation is not available until device initiation is complete.
Dispose of depleted batteries according to local requirements.
▪
6.
Insert the lead(s) into the external neurostimulator. Refer to "Inserting 4-contact
lead(s) into the wireless external neurostimulator" on page 18 or "Inserting 8-contact
lead(s) into the wireless external neurostimulator" on page 20 for instructions on
inserting the lead(s) into the external neurostimulator.
Note:
If replacing batteries during trial stimulation, ensure identical seating of the
lead(s) inside the lead grooves.
7.
Use either the clinician programmer or controller to turn stimulation on.
8.
Use the clinician programmer to perform the check connectivity task and confirm that
the lead(s) have been fully inserted into the correct lead grooves. For instructions on
the check connectivity task, refer to the clinician programming guide.
2017-06-01 English 17
9.
Secure the external neurostimulator to the patient. Refer to "Preparing the wireless
external neurostimulator for trial stimulation" on page 21 for instructions on securing
the external neurostimulator to the patient.
Connecting leads to the wireless external neurostimulator
The external neurostimulator has two lead housing compartments that each fit two 4-contact
leads and one 8-contact lead. The leads are inserted in lead grooves, which are numbered
0-7 on the white side and 8-15 on the black side (Figure 1). Leads are inserted in both of the
lead housing compartments.
If using four 4-contact leads, two are inserted in each housing compartment.
▪
If using two 8-contact leads, one is inserted in each housing compartment.
▪
If using two 4-contact leads and one 8-contact lead, the 4-contact leads are inserted in
▪
one housing compartment and the 8-contact lead must be inserted in the other.
Notes:
The 4-contact leads and the 8-contact leads are inserted into the external
▪
neurostimulator in the same direction.
The lead procedures apply to leads and extensions.
▪
Inserting 4-contact lead(s) into the wireless external
neurostimulator
Check battery status before inserting the lead(s) into the external neurostimulator. Refer to
the clinician programming guide for information on checking battery status.
Caution:
Before connecting components, wipe off any body fluids and dry all
connections. Fluids in the connection may result in intermittent stimulation or loss of
stimulation.
1.
Wipe the lead contacts with dry sterile gauze.
2.
Lift the lift tab on the appropriate lead housing compartment to open the clear lead
door (Figure 6a).
3.
Disconnect the long stylet handle from the 4-contact lead and withdraw the long stylet
from the 4-contact lead.
4.
Insert the short stylet into the 4-contact lead and connect the short stylet handle to the
4-contact lead.
5.
Make sure the lead contacts and the electrical contacts inside the lead grooves are dry
and clean.
6.
Align the short stylet and proximal end of the lead against the inside end of a 4-contact
lead groove of the connector (Figure 6a).
18 English 2017-06-01
Short stylet handle
ab
Lead groove numbering
Door latch
Electrical contacts
Lead groove
Figure 6. External neurostimulator with a 4-contact lead.
7.
Check that the lead contacts align with the electrical contacts inside the lead groove
and that the short stylet handle aligns with the stylet-shaped portion of the lead
groove (Figure 7).
Short stylet handle
Lead grooveElectrical contacts
Figure 7. Align the lead contacts with the electrical contacts in the lead groove.
Note:
The lead and short stylet fit only one way into the external neurostimulator lead
housing.
8.
Press the lead and short stylet gently into the lead groove (Figure 6b). If an additional
4-contact lead is used, repeat step 1 and steps 3 to 8.
2017-06-01 English 19
9.
Push the door(s) closed until the latch snaps firmly into place.
Note:
Do not force the doors closed; they should close easily. If they do not,
disassemble the components and repeat steps 2 to 9.
10.
Confirm correct seating by viewing the lead(s) through the closed doors.
11.
Refer to the clinician programming guide for instructions on how to reestablish
communication with the external neurostimulator and the clinician programmer, verify
proper connection, and identify optimal stimulation parameters.
Inserting 8-contact lead(s) into the wireless external
neurostimulator
Check battery status before inserting the lead(s) into the external neurostimulator. Refer to
the clinician programming guide for information on checking battery status.
Caution:
Before connecting components, wipe off any body fluids and dry all
connections. Fluids in the connection may result in intermittent stimulation or loss of
stimulation.
1.
Wipe the lead contacts with dry sterile gauze.
2.
Lift the lift tab on the appropriate lead housing compartment to open the clear lead
door (Figure 8a).
3.
Make sure the lead contacts and the electrical contacts inside the lead grooves are dry
and clean.
4.
While holding the 8-contact lead, disconnect the stylet handle from the lead (proximal
end), and partially withdraw the stylet.
Note:
If connecting an extension or a lead without a stylet, proceed to step 5.
5.
Align the proximal end of the lead against the inside end of an 8-contact lead groove
of the connector (Figure 8a).
Stylet handle
Electrical contacts
Figure 8. External neurostimulator with an 8-contact lead with the stylet partially
20 English 2017-06-01
ab
Lead groove
withdrawn.
Lead groove numbering
Door latch
Retainer clips
6.
Check that the lead contacts align with the electrical contacts inside the lead groove
(Figure 9).
Stylet handle
Lead grooveElectrical contacts
Figure 9. Align the lead contacts with the electrical contacts in the lead groove.
The lead fits only one way into the external neurostimulator lead housing.
Note:
7.
Press the lead gently into the lead groove and the retainer clip (Figure 8b). If an
additional 8-contact lead is used, repeat step 1 and steps 3 to 7.
8.
Push door(s) closed until the latch snaps firmly into place.
Note:
Do not force the doors closed; they should close easily. If they do not,
disassemble the components and repeat steps 2 to 8.
9.
Confirm correct seating by viewing the lead(s) through the closed doors.
10.
Refer to the clinician programming guide for instructions on how to reestablish
communication with the external neurostimulator and the clinician programmer, verify
proper connection, and identify optimal stimulation parameters.
Preparing the wireless external neurostimulator for trial
stimulation
Check the battery status and perform the check connectivity task before attaching the
external neurostimulator to the patient. Refer to the appropriate clinician programming
guide for information on checking battery status and the check connectivity task.
Note:
This procedure applies to leads and extensions.
1.
Place a gauze bandage on the skin where the lead(s) will be secured.
2017-06-01 English 21
2.
Tape the lead(s) to the patient's skin, providing strain relief loops.
Notes:
Allow enough strain relief to ensure that the lead(s) will not be bent or kinked when
▪
connected to the external neurostimulator.
Tape the strain relief loops separately from lead exit site dressing.
▪
3.
Tape the strain relief loops and lead(s) so that the tape ends at the external
neurostimulator.
Note:
Ensure that the lead(s) are taped separately from the external neurostimulator.
4.
Affix the external neurostimulator to the patient's skin, ensuring that the
faces away from the patient.
a. Use the external neurostimulator boot to adhere the external neurostimulator to
the patient's skin. The boot is not sterile, so complete this activity outside of the
sterile field. Refer to the external neurostimulator boot instructions for use. Ensure
ENS
that the
b. If not using the external neurostimulator boot, place a gauze bandage where the
external neurostimulator will be placed on the patient, then tape the external
neurostimulator to the patient's skin. Ensure that the
c. Ensure that the lead door seams or the external neurostimulator boot are not
completely covered by bandages or tape in order to reduce humidity and
condensation in the device, which may result in loss of stimulation. Ensure that the
ENS
5.
Proceed with the trial stimulation.
button is exposed.
button is exposed.
ENS
button is exposed.
Removing the wireless external neurostimulator after trial
stimulation
1.
Use the clinician programmer or controller to turn stimulation off.
2.
Remove all tape from the lead(s) and external neurostimulator.
3.
Lift the lift tabs to open the lead doors.
4.
Gently lift each lead from the electrical contacts in the lead groove.
Note:
Refer to the lead manual for instructions on the removal of the lead(s) following
trial stimulation, as appropriate.
5.
If required by local regulation, refer to the clinician programming guide for instructions
about how to update the patient data on the external neurostimulator for disposal.
6.
Dispose of the external neurostimulator according to environmental requirements.
ENS
button
Device care and storage
Keep new AAA alkaline batteries available. For optimal performance, use the same
▪
batteries as those supplied by Medtronic.
Use the clinician programmer or the controller to check the external neurostimulator
▪
battery level daily. For instructions on checking the external neurostimulator batteries,
refer to the appropriate clinician programming guide.
22 English 2017-06-01
Replace low or depleted batteries.
▪
Handle the device and system components with care. Do not drop, strike or step on
▪
the device or system components.
Do not dismantle or tamper with the device.
▪
Store the external neurostimulator at room temperature. Avoid extreme hot or cold
▪
temperatures and direct sunlight.
The device and system components are not waterproof. Do not allow moisture or
▪
condensation to get inside the device or system components.
Dispose of depleted batteries and devices according to local requirements.
▪
Safety and technical checks
Periodic safety and technical checks or periodic maintenance of the external
neurostimulator are not required.
The external neurostimulator contains no serviceable components. If the external
neurostimulator is nonfunctional, contact Medtronic. Refer to the list of Medtronic contacts
at the end of this manual.
2017-06-01 English 23
Contacts:
Asia:
Medtronic International Ltd.
Tel. 02919-1300
Fax 02891-6830
Medtronic Asia Ltd.
Tel. (02)-548-1148
Fax (02)-518-4786
Australia:
Medtronic Australasia P/L
5 Alma Road
Macquarie Park NSW 2113
Australia
Tel. +61-2-9857-9000
Fax +61-2-9878-5100
Toll-free 1-800-668-670
Austria:
Medtronic Österreich GmbH
Tel. 01-240440
Fax 01-24044-100
Medtronic International Trading Sàrl
Route du Molliau 31,
Case Postale 84
CH - 1131 Tolochenaz,
Switzerland
www.medtronic.eu
Tel. +41-21-802-7000
Fax +41-21-802-7900
Asia-Pacific
Medtronic International Ltd.
Suite 1106-11, 11/F, Tower 1, The Gateway,
25 Canton Road, Tsimshatsui,
Kowloon,
Hong Kong
Tel. +852-2919-1300
Fax +852-2891-6830
Contacts for specific countries are listed inside this cover.