| Brand Name | VADER® PEDICLE SYSTEM |
| Common Device Name | VADER® PEDICLE SYSTEM, ROD, CARBON/PEEK, CURVED, Ø 6.0 R450 <-> 200 MM |
| Manufacturer (Section D) |
| ICOTEC AG |
| industriestrasse 12 |
| altstaetten, sg 9450 |
| SZ 9450 |
|
| Manufacturer (Section G) |
| ICOTEC AG |
| industriestrasse 12 |
|
| altstaetten, sg 9450 |
|
SZ
9450
|
|
| Manufacturer Contact |
|
joerg
schneider
|
| industriestrasse 12 |
| altstaetten, sg 9450
|
|
SZ
9450
|
|
| MDR Report Key | 24532091 |
| Report Number | 3006493760-2026-00002 |
| Device Sequence Number | 8972044 |
| Product Code |
NKB
|
| UDI-Device Identifier | 07640172551905 |
| UDI-Public | 07640172551905 |
| Combination Product (Y/N) | N |
| Initial Reporter State | IN |
| Initial Reporter Country | US |
| PMA/510(K) Number | K242900 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| Report Date (Section B) |
03/06/2026 |
| 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? |
No
|
| Operator of Device |
Health Professional
|
| Device Catalogue Number | 16-60-24520 |
| Device Lot Number | 22/01 |
| 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 | 02/12/2026 |
| Initial Report FDA Received Date | 03/06/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 12/21/2022 |
| 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 Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Sex | Unknown |
|
|