METRX® SYSTEM
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
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.
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 |