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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MITG - TIJUANA KYPHON XPANDER¿ INFLATABLE BONE TAMP; ARTHROSCOPE

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MITG - TIJUANA KYPHON XPANDER¿ INFLATABLE BONE TAMP; ARTHROSCOPE Back to Search Results
Model Number K08A
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/16/2025
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 l2 bkp procedure in a patient diagnosed with compression fracture due to primary osteoporosis.It was reported that the balloon burst.There was a delay of less than 60 mins.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.
 
Additional Manufacturer Narrative
H3: product# k08a, lot# unknown visual and functional inspection revealed the tip of the balloon has been damaged and leaks when tested.The damage is consistent with the balloon coming in contact with bone spurs when the balloon is inflated in the vertebral body.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
KYPHON XPANDER¿ INFLATABLE BONE TAMP
Common Device Name
ARTHROSCOPE
Manufacturer (Section D)
MITG - TIJUANA
blvd. insurgentes parcela #37
tijuana, bc 22570
MX  22570
Manufacturer (Section G)
MITG - TIJUANA
blvd. insurgentes parcela #37
tijuana, bc 22570
MX   22570
Manufacturer Contact
justin ellis
1800 pyramid place
memphis, TN 38132
7635265677
MDR Report Key23932252
Report Number2936999-2025-00607
Device Sequence Number21239278
Product Code HRX
UDI-Device Identifier00763000311902
UDI-Public00763000311902
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K041454
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 03/24/2026
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 NumberK08A
Device Catalogue NumberK08A
Device Lot NumberUNKNOWN
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 12/17/2025
Supplement Date Received by Manufacturer03/24/2026
Initial Report FDA Received Date12/31/2025
Supplement Report FDA Received Date03/24/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
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 Number1
Patient SexUnknown
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