FDA Adverse Event Malfunction Summary report: N

INVICTUS SPINAL FIXATION SYSTEM

MDR report key: 22341220 · Received June 26, 2025

Report

Report Number
2027467-2025-00156
Event Type
Malfunction
Date Received
June 26, 2025
Date of Event
June 2, 2025
Report Date
June 26, 2025
Manufacturer
ALPHATEC SPINE, INC.
Product Code
HWX
UDI-DI
00190376192079
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE TAP HAS NOT RETURNED FOR EVALUATION. PHOTOGRAPHS WERE NOT PROVIDED. A REVIEW OF THE DEVICE HISTORY RECORDS COULD NOT BE PERFORMED AS THE IDENTIFYING LOT NUMBER WAS NOT PROVIDED. ALPHATEC SPINE IS SUBMITTING THIS REPORT TO COMPLY WITH THE FDA REGULATIONS 21 CFR 803. ALPHATEC SPINE HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS AVAILABLE. ANY FIELD THAT IS LEFT BLANK WAS NOT KNOWN AT THE TIME OF THIS SUBMISSION. IF ADDITIONAL INFORMATION IS PROVIDED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE TAP IS BROKEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1538093 INVICTUS SPINAL FIXATION SYSTEM TAP, BONE HWX ALPHATEC SPINE, INC. 17109-055 00190376192079

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown