FDA Adverse Event Malfunction Summary report: N

METRX® SYSTEM

MDR report key: 22530849 · Received July 17, 2025

Report

Report Number
1030489-2025-02454
Event Type
Malfunction
Date Received
July 17, 2025
Report Date
July 17, 2025
Manufacturer
MEDTRONIC SOFAMOR DANEK USA, INC
Product Code
HRX
UDI-DI
00885074210353
PMA / PMN Number
K002931
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H3: PRODUCT ANALYSIS OF PRODUCT: 9560100, LOTNO: 944110 ANALYSIS FOUND DURING THE INCOMING INSPECTION, SCRATCHES AND IMAGE CLOUDINESS OF THE OUTER TUBE WERE OBSERVED. B3: EVENT DATE IS UNKNOWN E1: INITIAL REPORTER IS UNKNOWN. 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 HEALTHCARE PROVIDER (HCP) VIA A MANUFACTURER REPRESENTATIVE REGARDING A PATIENT HAVING SPINAL THERAPY. IT WAS REPORTED THAT THE SCOPE WAS CLOUDY. THERE WAS NO PATIENT SYMPTOM REPORTED. THERE WERE NO FURTHER COMPLICATIONS REPORTED REGARDING THE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
808623 METRX® SYSTEM ARTHROSCOPE HRX MEDTRONIC SOFAMOR DANEK USA, INC 9560100 944110 00885074210353

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown