CD HORIZON SOLERA VOYAGER SPINAL SYSTEM
Report
- Report Number
- 3003120897-2025-00528
- Event Type
- Malfunction
- Date Received
- November 10, 2025
- Date of Event
- October 17, 2025
- Report Date
- November 10, 2025
- Manufacturer
- MEDTRONIC SOFAMOR DANEK USA, INC.
- Product Code
- HWE
- UDI-DI
- 00643169754584
- PMA / PMN Number
- K170679
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IN, US
- Reporter Occupation
- 003
Narratives
H3. DEVICE EVALUATION SUMMARY: PRODUCT ANALYSIS #(B)(4) :6550017; LOT# K24L1119 VISUAL AND OPTICAL EXAMINATION REVEALED THE TIP OF THE INSTRUMENT IS BENT FROM WHAT APPEARS TO BE OVERLOAD. THIS IS CONSISTENT WITH OVERLOAD. 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 USER FACILITY VIA A MANUFACTURER REPRESENTATIVE REGARDING THE DEVICES USED FOR SPINAL THERAPY. IT WAS REPORTED THAT THE EXTENDERS WERE FOUND TO BE BENT. THERE WAS NO PATIENT INVOLVED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1781954 | CD HORIZON SOLERA VOYAGER SPINAL SYSTEM | INSTRUMENT, SURGICAL, ORTHOPEDIC, AC-POWERED M | HWE | MEDTRONIC SOFAMOR DANEK USA, INC. | 6550017 | K24L1119 | 00643169754584 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |