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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC SOFAMOR DANEK USA, INC. ELEVATE¿ SPINAL SYSTEM; ORTHOPEDIC STEREOTAXIC INSTRUMENT

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MEDTRONIC SOFAMOR DANEK USA, INC. ELEVATE¿ SPINAL SYSTEM; ORTHOPEDIC STEREOTAXIC INSTRUMENT Back to Search Results
Model Number NAV2132
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/08/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
E: first name and last name of initial reporter is unknown.Facility name is unknown.H3: product analysis of part#: nav2132, lot#: dn20k001 visual and optical examination identified that the elevate inserter has broken on the outer shaft where the shaft and handle interface.The break occurred at the locking tab cutouts.A microscopic analysis of the fracture surface indicates a brittle fracture.The fracture appears to have occurred from the material attempting to shift during compression.This is consistent with the instrument being struck from the back side.The center shaft was not returned so witness marks on the back could not be observed.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.
 
Event or Problem Description
Information was received from user facility via a manufacturer representative regarding a device used for spinal therapy.It was reported that the device handle was completely snapped off.There was no patient involvement reported and no further complications reported regarding the event.
 
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Brand Name
ELEVATE¿ SPINAL SYSTEM
Common Device Name
ORTHOPEDIC STEREOTAXIC INSTRUMENT
Manufacturer (Section D)
MEDTRONIC SOFAMOR DANEK USA, INC.
4340 swinea rd
memphis TN 38118
Manufacturer (Section G)
MEDTRONIC SOFAMOR DANEK USA, INC.
4340 swinea rd
memphis TN 38118
Manufacturer Contact
justin ellis
1800 pyramid place
memphis, TN 38132
7635265677
MDR Report Key23665355
Report Number3003120897-2025-00629
Device Sequence Number10401611
Product Code OLO
UDI-Device Identifier00763000141400
UDI-Public(01)00763000141400(11)210212(10)DN20K001
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K163581
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 11/27/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Other
Device Model NumberNAV2132
Device Catalogue NumberNAV2132
Device Lot NumberDN20K001
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/03/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/03/2025
Initial Report FDA Received Date11/27/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/12/2021
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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