FDA Adverse Event Malfunction Summary report: N

SOLERA VOYAGER 5.5

MDR report key: 24266509 · Received February 5, 2026

Report

Report Number
3003120897-2026-00193
Event Type
Malfunction
Date Received
February 5, 2026
Date of Event
November 30, 2025
Report Date
February 5, 2026
Manufacturer
MEDTRONIC SOFAMOR DANEK USA, INC.
Product Code
HXX
UDI-DI
00643169961562
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H3: PRODUCT ANALYSIS OF PART # 6550006 ; LOT # K24H1339 VISUAL AND OPTICAL INSPECTION CONFIRMED ONE OF THE RETAINING TABS AT THE TIP OF THE DRIVER HAS BROKEN. THE DAMAGE TO THE TAB 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.

Description of Event or Problem · 0

INFORMATION WAS RECEIVED FROM HEALTHCARE PROVIDER (HCP) VIA A MANUFACTURER REPRESENTATIVE REGARDING A PATIENT HAVING SPINAL THERAPY. IT WAS REPORTED THAT, THE DRIVER TIP WAS BENT TOGETHER, SO IT WON¿T RETAIN SET SCREWS. THERE WERE NO PATIENT SYMPTOMS REPORTED. NO FURTHER COMPLICATIONS REPORTED REGARDING THE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
331194 SOLERA VOYAGER 5.5 SCREWDRIVER HXX MEDTRONIC SOFAMOR DANEK USA, INC. 6550006 K24H1339 00643169961562

Patients

Seq Age Sex Outcome Treatment
1 NA Female