FDA Adverse Event Malfunction Summary report: N

ZEVO¿ ANTERIOR CERVICAL PLATE SYSTEM

MDR report key: 21187791 · Received January 19, 2025

Report

Report Number
1030489-2025-00247
Event Type
Malfunction
Date Received
January 19, 2025
Report Date
January 19, 2025
Manufacturer
MEDTRONIC SOFAMOR DANEK USA, INC
Product Code
HXX
UDI-DI
00643169342293
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

H3: PRODUCT ANALYSIS: PART# 3030007 LOT# IM21B018 VISUAL AND OPTICAL EXAMINATION IDENTIFIED THAT THE TIP OF THE SCREWDRIVER IS WORN FROM WHAT APPEARS TO BE REPEATED NORMAL USE. THIS IS CONSISTENT WITH ANTICIPATED WEAR. H11: THIS REGULATORY REPORT IS BEING SUBMITTED DUE TO RETROSPECTIVE REVIEW THROUGH CAPA 624392. 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

INFORMATION WAS RECEIVED FROM A MANUFACTURER REPRESENTATIVE REGARDING AN EVENT. IT WAS REPORTED THAT INSTRUMENTS ARE EITHER BROKEN OR WORN. THERE WAS NO PATIENT INVOLVEMENT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1464585 ZEVO¿ ANTERIOR CERVICAL PLATE SYSTEM SCREWDRIVER HXX MEDTRONIC SOFAMOR DANEK USA, INC 3030007 IM21B018 00643169342293

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown