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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET SPINE INC. SEQUOIA OPEN CLOSURE, 5.5M, TOP TI; SEQUOIA PEDICLE SCREW SYSTEM INCLUDING SPEEDLINK II TRANSVERSE CONNECTOR SYSTEM

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ZIMMER BIOMET SPINE INC. SEQUOIA OPEN CLOSURE, 5.5M, TOP TI; SEQUOIA PEDICLE SCREW SYSTEM INCLUDING SPEEDLINK II TRANSVERSE CONNECTOR SYSTEM Back to Search Results
Catalog Number 3301-1
Device Problem Material Deformation (2976)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 07/13/2020
Event Type  malfunction  
Manufacturer Narrative
Without a product return, no product evaluation is able to be conducted.Current information is insufficient to permit a valid conclusion about the cause of this event.If additional information is obtained that adds value to the relevant content of this report and/or a conclusion can be drawn, a follow-up report will be sent.Reference reports 3012447612-2020-00434 to 3012447612-2020-00444.
 
Event Description
It was reported a screw was removed and replaced after ten set screws were stripped in the pedicle screw tulip head.An alternate screw and set screw were used to complete the case with no reported patient harm.This is report four of eleven for this event.
 
Event Description
No further event information available at the time of this report.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.D4: udi#: (b)(4).D6: not implanted.D7: not explanted.D11: catalog#: 3505-6540 6.5x40mm path nxt cann pa scr lot#: 88mw qty: 1; catalog#: 3301-1 sequoia closure top lot#: aas qty: 2; catalog#: 3301-1 sequoia closure top lot#: aax qty: 7.The following sections were updated/corrected updated: b4, b5, d10, d11, g4, g7, h2, h3, h4, h6, h10; corrected: d6, d7.The event is confirmed with product received.Upon inspection, the closure tops showed bent threads and did not function as intended.Dhr was reviewed and no discrepancies relevant to the reported event were found.Root cause was unable to be determined.If any further information is found which would change or alter any conclusions or information, a supplemental will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
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Brand Name
SEQUOIA OPEN CLOSURE, 5.5M, TOP TI
Type of Device
SEQUOIA PEDICLE SCREW SYSTEM INCLUDING SPEEDLINK II TRANSVERSE CONNECTOR SYSTEM
Manufacturer (Section D)
ZIMMER BIOMET SPINE INC.
10225 westmoor dr.
westminster CO 80021
MDR Report Key10386035
MDR Text Key202406683
Report Number3012447612-2020-00437
Device Sequence Number1
Product Code NKB
Combination Product (y/n)N
PMA/PMN Number
K131980
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Type of Report Initial,Followup
Report Date 10/20/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/10/2020
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number3301-1
Device Lot NumberAAS
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/01/2020
Was the Report Sent to FDA? No
Date Manufacturer Received10/19/2020
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient Age34 YR
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