FDA Adverse Event Malfunction Summary report: N

CORNERSTONE-SR® TI-COATED CAGE SYSTEM

MDR report key: 23220045 · Received October 6, 2025

Report

Report Number
3011795235-2025-00017
Event Type
Malfunction
Date Received
October 6, 2025
Report Date
April 14, 2026
Manufacturer
MSD DEGGENDORF MFG
Product Code
ODP
PMA / PMN Number
SEE H11
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

G4: THIS PRODUCT IS NOT APPROVED FOR SALE IN US BUT A SIMILAR DEVICE WITH CATALOG#: 5030564 AND 510K#: K133653 IS APPROVED FOR SALE IN US. 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.

Additional Manufacturer Narrative · 0

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.

Additional Manufacturer Narrative · 0

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 MULTIPLE SOURCES (PATIENT, MANUFACTURER REPRESENTATIVE, HEALTHCARE PROVIDER) REGARDING A PATIENT IMPLANTED WITH CAGE HAVING SPINAL THERAPY. IT WAS REPORTED THAT THE IMPLANTS WERE BROKEN AND PATIENT SYMPTOMS WERE UNKNOWN. REVISION SURGERY WAS PERFORMED TO EXPLANT IMPLANTS ON (B)(6) 2025. EVENT OCCURRED POST-OP AND LEVEL IMPLANTED ¿ CERVICAL VERTEBRAE 5/6 AND 6/7. THERE WERE NO FURTHER COMPLICATIONS REPORTED REGARDING THE EVENT.

Description of Event or Problem · 0

ADDITIONAL INFORMATION RECEIVED THAT THESE IMPLANTS WERE MASSIVELY CORRODED AND DISINTEGRATED. THIS RESULTED IN SEVERE METALLOSIS, SYSTEMIC SWELLING, AND LIFE-THREATENING INFLAMMATION LEVELS.

Description of Event or Problem · 0

ADDITIONAL INFORMATION RECEIVED THAT PATIENT HAD SIGNIFICANT NECK SWELLING, VENOUS PROBLEMS, FACIAL AND BODY SWELLING, AND CATASTROPHIC BLOOD TEST RESULTS. AFTER IMPLANTS WERE EXPLANTED, PATIENT'S CONDITION WAS GETTING BETTER, BUT THE SWELLING RETURNED AND WORSENED. PATIENT ALSO HAD PAINS LIKE BROKEN LIMBS (IN EPISODES) IN FINGERS, ANKLES, KNEES, AND SPREADING THROUGHOUT THE BODY. ON AN MRI, METAL FRAGMENTS WERE VISIBLE AT THE SURGICAL SITE. PATIENT WAS ALLERGIC TO NICKEL, AND BLOOD PRESSURE WAS HIGH AND HAD HEART AND LUNG PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
183054 CORNERSTONE-SR® TI-COATED CAGE SYSTEM INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, ODP MSD DEGGENDORF MFG 6221404 09RE

Patients

Seq Age Sex Outcome Treatment
1