| Brand Name | 5.5/6.0 POLYAXIAL PEDICLE SCREWS - Ø6.5MM, 40MM LENGTH |
| Common Device Name | 5.5/6.0 POLYAXIAL PEDICLE SCREWS - Ø6.5MM, 40MM LENGTH |
| Manufacturer (Section D) |
| ORTHOPEDIATRICS |
| 2850 frontier drive |
| warsaw IN 46582 |
|
| Manufacturer (Section G) |
| ORTHOPEDIATRICS, CORP |
| 2850 frontier drive |
|
| warsaw IN |
|
| Manufacturer Contact |
|
james
gunnels
|
| 2850 frontier drive |
| warsaw, IN
|
|
| MDR Report Key | 24486325 |
| Report Number | 3006460162-2026-00007 |
| Device Sequence Number | 5017277 |
| Product Code |
NKB
|
| UDI-Device Identifier | 00841132131299 |
| UDI-Public | 00841132131299 |
| Combination Product (Y/N) | N |
| Initial Reporter State | MO |
| Initial Reporter Country | US |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2023 |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Report Source |
Company Representative |
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial |
| Report Date (Section B) |
03/02/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
Yes
|
| Is this a Product Problem Report? |
Yes
|
| Device Model Number | 00-1300-7640 |
| Was Device Available for Evaluation? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 02/09/2026 |
| Initial Report FDA Received Date | 03/02/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Other;
|
| Patient Sex | Female |
|
|