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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: K2M, INC. ADJUSTABLE INSERTER; TLIF II; INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, LUMBAR

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K2M, INC. ADJUSTABLE INSERTER; TLIF II; INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, LUMBAR Back to Search Results
Catalog Number 3303-90603
Medical Device Problem Codes Fracture (1260); Material Deformation (2976); Mechanical Jam (2983)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/03/2026
Type of Reportable Event Malfunction
Event or Problem Description
A company representative reported that an aleutian tlif ii adjustable inserter was difficult to disassemble from a cage and that an aleutian tlif ii adjustable inserter inner shaft was "broken" intra-operatively.The procedure was completed successfully with no surgical delay and no adverse consequence to the patient.This report captures the inserter.
 
Additional Manufacturer Narrative
H6 coding has been updated to reflect completion of the investigation.
 
Event or Problem Description
No new information.
 
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Brand Name
ADJUSTABLE INSERTER; TLIF II
Common Device Name
INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, LUMBAR
Manufacturer (Section D)
K2M, INC.
600 hope pkwy
leesburg VA 20175
Manufacturer (Section G)
K2M, INC.
600 hope pkwy
leesburg VA 20175
Manufacturer Contact
catherine devarenne
2 pearl court
allendale, NJ 07401
2017608000
MDR Report Key24503623
Report Number3004774118-2026-00070
Device Sequence Number13247527
Product Code MAX
UDI-Device Identifier10888857157668
UDI-Public(01)10888857157668(11)141203(10)APBE014
Combination Product (Y/N)N
Initial Reporter CountryAS
PMA/510(K) Number
K160547
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup,Followup
Report Date (Section B) 05/20/2026
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 Catalogue Number3303-90603
Device Lot NumberAPBE014
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/04/2026
Supplement Date Received by Manufacturer03/26/2026
04/21/2026
Initial Report FDA Received Date03/03/2026
Supplement Report FDA Received Date03/30/2026
05/20/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/03/2014
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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