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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 12/18/2025
Type of Reportable Event Malfunction
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.
 
Event or Problem Description
Information was received from healthcare provider (hcp) via a manufacturer representative regarding an event which occurred during an unknown spinal kyphoplasty procedure in a patient.It was reported that the balloon couldn't get through the osteoinducer.It was too thick and the other balloon ruptured.There was no patient symptom reported.There were no further complications reported regarding the event.
 
Additional Manufacturer Narrative
B5: event details updated h6: products were discarded.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
Products were discarded.
 
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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 Key23932260
Report Number2936999-2025-00608
Device Sequence Number21239281
Product Code HRX
UDI-Device Identifier00763000311902
UDI-Public00763000311902
Combination Product (Y/N)N
Initial Reporter CountryGM
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) 04/09/2026
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 12/18/2025
Supplement Date Received by Manufacturer03/20/2026
Initial Report FDA Received Date12/31/2025
Supplement Report FDA Received Date04/09/2026
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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