CD HORIZON® SPINAL SYSTEM
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
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.
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.
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 |