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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: WARSAW ORTHOPEDIC, INC. PRESTIGE CERVICAL DISC SYSTEM; PROSTHESIS, INTERVERTEBRAL DISC

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WARSAW ORTHOPEDIC, INC. PRESTIGE CERVICAL DISC SYSTEM; PROSTHESIS, INTERVERTEBRAL DISC Back to Search Results
Model Number 6973060
Medical Device Problem Codes Degraded (1153); Mechanical Problem (1384)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/16/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
D4: lot number is unknown.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 a patient having anterior cervical discectomy and fusion (acdf) procedure at levels 5-7 for a pre-operative diagnosis of herniated nucleus pulposus.It was reported that three inserters have been broken and no longer attached to the implants.No patient complications have been reported as a result of this event.Additional information was received from the manufacturer representative that there was an instrument incompatibility which might be due to wear issue and not breakage.
 
Additional Manufacturer Narrative
H3: product analysis of product:6973060, lot:em20a046 visual and optical inspection confirmed the inserter is worn from repeated use.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
PRESTIGE CERVICAL DISC SYSTEM
Common Device Name
PROSTHESIS, INTERVERTEBRAL DISC
Manufacturer (Section D)
WARSAW ORTHOPEDIC, INC.
2500 silveus crossing
warsaw IN 46582
Manufacturer (Section G)
WARSAW ORTHOPEDIC, INC.
2500 silveus crossing
warsaw IN 46582
Manufacturer Contact
justin ellis
1800 pyramid place
memphis, TN 38132
7635265677
MDR Report Key24288233
Report Number1824199-2026-00014
Device Sequence Number9388303
Product Code MJO
UDI-Device Identifier00613994714848
UDI-Public(01)00613994714848(11)200318(10)EM20A046
Combination Product (Y/N)N
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
P090029
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 03/16/2026
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 Number6973060
Device Catalogue Number6973060
Device Lot NumberEM20A046
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/16/2026
Supplement Date Received by Manufacturer02/27/2026
Initial Report FDA Received Date02/08/2026
Supplement Report FDA Received Date03/16/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/18/2020
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 SexUnknown
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