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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MDT PUERTO RICO OPERATIONS CO, MED REL CD HORIZON® SOLERA® VOYAGER¿ SPINAL SYSTEM; THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM

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MDT PUERTO RICO OPERATIONS CO, MED REL CD HORIZON® SOLERA® VOYAGER¿ SPINAL SYSTEM; THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM Back to Search Results
Model Number 55750027540
Medical Device Problem Code Malposition of Device (2616)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/11/2025
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 a healthcare professional regarding a patient having spinal therapy for primary osteoporosis (compression fracture).It was reported that when 0.8cc of cement was injected from one side into t10, it was noticed that the cement had leaked, so a ct scan was performed immediately.The cement appeared to have spread horizontally across the anterior surface of the vertebral body, possibly segmentally.It did not reach any major blood vessels.No additional cement was injected; the wound was closed after rod implantation.There was no issue with the screw itself; it was suspected that there isan issue with screw placement position.There was no patient symptom reported.There were no further complications reported regarding the event.
 
Additional Manufacturer Narrative
Radiographic image review: lateral fluoroscopy shows pedicle screws with cement augmentation (levels not specified).Lateral x-ray shows no obvious cement extravasation.Ap view suggests a t10¿l2 construct.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
THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM
Manufacturer (Section D)
MDT PUERTO RICO OPERATIONS CO, MED REL
road 909, km. 0.4., barrio mar
humacao PR 00792
Manufacturer (Section G)
MDT PUERTO RICO OPERATIONS CO, MED REL
road 909, km. 0.4., barrio mar
humacao PR 00792
Manufacturer Contact
justin ellis
1800 pyramid place
memphis, TN 38132
7635265677
MDR Report Key23959075
Report Number2647346-2026-00004
Device Sequence Number17545265
Product Code NKB
UDI-Device Identifier00763000149161
UDI-Public(01)00763000149161(17)300328(10)H6042398
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K170679
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Reporter Type Manufacturer
Report Source Foreign,Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 02/25/2026
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 Number55750027540
Device Catalogue Number55750027540
Device Lot NumberH6042398
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 12/11/2025
Supplement Date Received by Manufacturer02/04/2026
Initial Report FDA Received Date01/05/2026
Supplement Report FDA Received Date02/25/2026
Date Device Manufactured03/28/2025
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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