FDA Adverse Event Malfunction Summary report: N

CD HORIZON® SPINAL SYSTEM

MDR report key: 24033154 · Received January 12, 2026

Report

Report Number
3003120897-2026-00063
Event Type
Malfunction
Date Received
January 12, 2026
Date of Event
December 18, 2025
Report Date
March 11, 2026
Manufacturer
MEDTRONIC SOFAMOR DANEK USA, INC.
Product Code
KWP
UDI-DI
00643169406377
PMA / PMN Number
K132639
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

E1: INITIAL REPORTER DETAILS ARE 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.

Additional Manufacturer Narrative · 0

H3: PRODUCT ANALYSIS: PRODUCT ID# 9010000849; LOT # K24G1142 VISUAL AND FUNCTIONAL INSPECTION THE INNER SHAFT DOES NOT MOVE WHEN THE LOCKING LEVER IS MOVED. THE "C" CLIP THAT CONNECTS THE ADJUSTING MECHANISM TO THE SHAFT APPEARS TO HAVE COME OUT. THE INNER SHAFT HAS BECOME UNTHREADED AND WILL NO LONGER THREAD BACK IN. IT IS POSSIBLE TO OVERLOAD THE CLIP IF MAKING TENSION ADJUSTMENTS WHILE THE ROD IS IN PLACE. IT APPEARS THAT THE CLIP MAY HAVE BEEN OVERLOADED. 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. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Description of Event or Problem · 0

INFORMATION WAS RECEIVED FROM MULTIPLE SOURCES (MANUFACTURER REPRESENTATIVE, USER FACILITY) REGARDING A DEVICE USED IN A SPINAL THERAPY. IT WAS REPORTED THAT THE INSERTER DID NOT CLAMP DOWN ONTO THE ROD OR TIGHTEN AT ALL, AND THE INSTRUMENT BROKE. THERE WAS NO PATIENT INVOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
94587 CD HORIZON® SPINAL SYSTEM APPLIANCE, FIXATION, SPINAL INTERLAMINAL KWP MEDTRONIC SOFAMOR DANEK USA, INC. 9010000849 K24G1142 00643169406377

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown