MAUDE Adverse Event Report: ZIMMER BIOMET SPINE, INC. POLYAXIAL SCREW, DIA. 8.5MM X 50MM; THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM

Catalog Number	709M8550
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Codes	Pain (1994); Inadequate Osseointegration (2646)
Date of Event	02/17/2025
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
D4: the remainder of the udi number is unknown because the lot number is not available.Without a product return, no product evaluation is able to be conducted.The lot number is unknown; therefore the device history records are unable to be reviewed.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.
Event or Problem Description
It was reported that a patient presented with low back and bilateral gluteal pain approximately 18 months post-op from an l3-s1 posterior fusion.The patient was taking pain medication.A subsequent ct scan showed lucency and some movement around the screws at s1, with partial to near-complete healing as well as grade 1 retrospondylolisthesis at l2-3 of 5mm.A revision surgery was performed where one of the screws at s1 was found to have fractured at the neck and the second screw at s1 was found to be loose in the bone along with pseudoarthrosis at l5-s1.Both the s1 screws were removed and replaced with larger diameter screws.The surgeon also extended the construct to l2 for the adjacent disc degeneration.This is report one of two for this event.
Event or Problem Description
It was reported that a patient presented with low back and bilateral gluteal pain approximately 18 months post-op from an l3-s1 posterior fusion.The patient was taking pain medication.A subsequent ct scan showed lucency and some movement around the screws at s1, with partial to near-complete healing as well as grade 1 retrospondylolisthesis at l2-3 of 5mm.A revision surgery was performed where one of the screws at s1 was found to have fractured at the neck and the second screw at s1 was found to be loose in the bone along with pseudoarthrosis at l5-s1.Both the s1 screws were removed and replaced with larger diameter screws.The surgeon also extended the construct to l2 for the adjacent disc degeneration.This is report one of two for this event.
Additional Manufacturer Narrative
H6: additional method code: 4110.Additional information in h6: investigation type, findings, and conclusions.Device evaluation: the device was not returned, however an x-ray image was provided which shows a screw has fractured.Root cause: a definitive root cause cannot be determined with the information provided.This event could possibly be attributed to unknown patient or surgical factors.Dhr review: the lot number was not reported and the device was not returned, therefore a dhr review is unable to be performed.Device usage: this device is used for treatment.If additional information is obtained that adds value to the relevant content of this report, a follow-up report will be sent.Reference report 3012447612-2025-00140.

• Brand Name: POLYAXIAL SCREW, DIA. 8.5MM X 50MM
• Common Device Name: THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM
• Manufacturer (Section D): ZIMMER BIOMET SPINE, INC.; 10225 westmoor dr.; westminster CO 80021
• Manufacturer (Section G): ZIMMER BIOMET SPINE, INC.; 10225 westmoor dr.; westminster CO 80021
• Manufacturer Contact: teresa george ; 10225 westmoor dr.; westminster, CO 80021 ; 3035018506
• MDR Report Key: 21679756
• Report Number: 3012447612-2025-00139
• Device Sequence Number: 7600383
• Product Code: NKB
• UDI-Device Identifier: 00880304868366
• UDI-Public: (01)00880304868366
• Combination Product (Y/N): N
• Initial Reporter State: MA
• Initial Reporter Country: US
• PMA/510(K) Number: K171907
• Exemption Number: 5645646
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2023
• Device Explanted Year: 2025
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Health Professional,Distributor
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date (Section B): 08/24/2025

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Operator of Device: Lay User/Patient
• Device Catalogue Number: 709M8550
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: Not provided
• Supplement Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 03/24/2025
• Supplement Report FDA Received Date: 08/25/2025
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Other; Required Intervention; Hospitalization
• Patient Age: 75 YR
• Patient Sex: Female
• Patient Ethnicity: Non Hispanic