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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MSD DEGGENDORF MFG DIVERGENCE¿ ANTERIOR CERVICAL FUSION SYSTEM; INTERVERTEBRAL FUSION DEVICE WITH INTEGRATED F

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MSD DEGGENDORF MFG DIVERGENCE¿ ANTERIOR CERVICAL FUSION SYSTEM; INTERVERTEBRAL FUSION DEVICE WITH INTEGRATED F Back to Search Results
Model Number G6626526
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/05/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
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 spinal therapy.It was reported that a zero-profile interbody fusion device fractured.The screw hole ofthe fusion device was damaged, which allowed the screw to advance into the vertebral body and prevented successful fixation.As a result, the device was completely explanted and replaced during the procedure.There was no patient symptom reported.There were no further complications reported regarding the event.
 
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Brand Name
DIVERGENCE¿ ANTERIOR CERVICAL FUSION SYSTEM
Common Device Name
INTERVERTEBRAL FUSION DEVICE WITH INTEGRATED F
Manufacturer (Section D)
MSD DEGGENDORF MFG
wertstrasse 17
deggendorf,de 94469
GM  94469
Manufacturer (Section G)
MSD DEGGENDORF MFG
wertstrasse 17
deggendorf,de 94469
GM   94469
Manufacturer Contact
justin ellis
1800 pyramid place
memphis, TN 38132
7635265677
MDR Report Key24696977
Report Number3011795235-2026-00013
Device Sequence Number18751871
Product Code OVE
UDI-Device Identifier00643169337497
UDI-Public(01)00643169337497(17)330826(10)46TK
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K141599
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
Device Explanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 03/26/2026
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 NumberG6626526
Device Catalogue NumberG6626526
Device Lot Number46TK
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 03/05/2026
Initial Report FDA Received Date03/26/2026
Date Device Manufactured08/26/2025
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 Number1
Patient SexUnknown
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