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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC SOFAMOR DANEK USA, INC. CD HORIZON® SOLERA® VOYAGER¿ SPINAL SYSTEM; SCREWDRIVER

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MEDTRONIC SOFAMOR DANEK USA, INC. CD HORIZON® SOLERA® VOYAGER¿ SPINAL SYSTEM; SCREWDRIVER Back to Search Results
Model Number 6550003
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/17/2025
Type of Reportable Event Malfunction
Event or Problem Description
Information was received from healthcare provider (hcp) via a manufacturer representative regarding an event which occurred during a t12-l2 posterior spinal fusion procedure in a patient diagnosed with compression fracture.It was reported that tip of the driver broke off.There was no patient symptom reported.There were no further complications reported regarding the event.
 
Additional Manufacturer Narrative
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.
 
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Brand Name
CD HORIZON® SOLERA® VOYAGER¿ SPINAL SYSTEM
Common Device Name
SCREWDRIVER
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 Key23808691
Report Number3003120897-2025-00736
Device Sequence Number15800214
Product Code HXX
UDI-Device Identifier00643169754508
UDI-Public(01)00643169754508(11)230405(10)K22L3292
Combination Product (Y/N)N
Initial Reporter StateNY
Initial Reporter CountryUS
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 12/16/2025
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 Health Professional
Device Model Number6550003
Device Catalogue Number6550003
Device Lot NumberK22L3292
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/17/2025
Initial Report FDA Received Date12/15/2025
Date Device Manufactured04/05/2023
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 Reuse
Patient Sequence Number1
Patient Age34 YR
Patient SexMale
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