FDA Adverse Event Malfunction Summary report: N

N/A

MDR report key: 21286240 · Received January 31, 2025

Report

Report Number
1723170-2025-00410
Event Type
Malfunction
Date Received
January 31, 2025
Date of Event
January 9, 2025
Report Date
January 31, 2025
Manufacturer
MEDRONIC INC
Product Code
MAX
PMA / PMN Number
K983670
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

CONTINUATION OF D10: SECTION D INFORMATION REFERENCES THE MAIN COMPONENT OF THE SYSTEM. OTHER RELEVANT DEVICE(S) ARE: SURGN CART 9735665 STEALTH S8 PREMIUM SW KIT 9735740 STEALTH S8 SPINE ARRAY 961579 SURETRAK2 MEDIUM PASSIVE ARRAY 961581 SURETRAK2 LARGE PASSIVE H3) NO PARTS HAVE BEEN RETURNED FOR ANALYSIS. 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

MEDTRONIC RECEIVED INFORMATION REGARDING A NAVIGATION SYSTEM BEING USED DURING A SACROILIAC AND THORACOLUMBAR PROCEDURE. IT WAS REPORTED THAT DURING A SACROILIAC AND THORACOLUMBAR PROCEDURE, THE SURETRAK APPEARED INACCURATE IN THE SOFTWARE BY 1MM MEDIAL. THE SURGEON REMOVED THE SURETRAK FROM THE DRILL GUIDE AND USED A HAND-POWERED AWL TO COMPLETE THE PROCEDURE. AFTER THE PROCEDURE, TESTING OF THE SURETRAK'S WAS CONDUCTED, AND THE ISSUE WAS REPLICATED. THE BLACK SURETRAK HAD A GEOMETRY ERROR OF 0.45, ONE OF ITS SPHERES WAS NOT VISIBLE, AND IT WAS UNABLE TO NAVIGATE CONSISTENTLY. TESTING WITH A SECOND SET OF SURETRAKS DID NOT REPLICATE THE ISSUE. THERE WAS NO REPORTED IMPACT TO PATIENT OUTCOME AND NO REPORTED DELAY. THE COMPLAINT REGARDING THE ACCURACY ISSUE WAS MADE AGAINST ALL THREE NAVLOCKS. HOWEVER, WHEN PERFORMING A SYSTEM CHECKOUT, ONLY THE BLACK NAVLOCK SHOWED PHYSICAL EVIDENCE WHERE ONE OF THE SPHERE WAS NOT TRACKABLE BY THE CAMERA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
510932 N/A INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, MAX MEDRONIC INC 9731567 347853

Patients

Seq Age Sex Outcome Treatment
1 75 YR Male