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U.S. Department of Health and Human Services

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

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K2M, INC. STRAIGHT INSERTER, INNER SHAFT; TLIF II; INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, LUMBAR Back to Search Results
Catalog Number 3303-90152
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/17/2026
Type of Reportable Event Malfunction
Event or Problem Description
A customer reported that the tip of an aleutian tlif ii straight inserter inner shaft fractured intra-operatively.The procedure was completed successfully with no surgical delay and no adverse consequence to the patient.
 
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Brand Name
STRAIGHT INSERTER, INNER SHAFT; 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 se
leesburg VA 20175
Manufacturer Contact
catherine devarenne
2 pearl court
allendale, NJ 07401
2017608000
MDR Report Key24521620
Report Number3004774118-2026-00077
Device Sequence Number9704101
Product Code MAX
UDI-Device Identifier10888857076617
UDI-Public10888857076617
Combination Product (Y/N)N
Initial Reporter CountrySF
PMA/510(K) Number
K150481
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 06/25/2026
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 Catalogue Number3303-90152
Device Lot NumberUEGV
Was Device Available for Evaluation? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/18/2026
Supplement Date Received by Manufacturer05/26/2026
Initial Report FDA Received Date03/05/2026
Supplement Report FDA Received Date06/25/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/19/2023
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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