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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 G6626746
Medical Device Problem Code Osseointegration Problem (3003)
Health Effect - Clinical Code Inadequate Osseointegration (2646)
Date of Event 01/17/2026
Type of Reportable Event Serious Injury
Event or Problem Description
Information was received from multiple sources (healthcare provider, clinical study) regarding a patient having posterior cervical laminectomy.It was reported that implants were used during an index posterior spinal fixation and fusion from skull to c7.An additional spinal revision surgery was performed because of fusion failure.No assessment of product, therapy, or procedure relatedness was made by the investigator, sponsor, or cec.
 
Additional Manufacturer Narrative
H6: neither the device nor films of applicable imaging studies were returned to the manufacturer for evaluation.Therefore, we are unable to determine the definitive cause of the reported event.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.
 
Additional Manufacturer Narrative
B5: additional information was received.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
Additional information was received that there was no associated malfunction reported.
 
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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 Key24893787
Report Number3011795235-2026-00016
Device Sequence Number9900067
Product Code OVE
UDI-Device Identifier00643169337473
UDI-Public(01)00643169337473(17)330826(10)76TK
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K141599
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Study,Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 05/25/2026
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
Operator of Device Health Professional
Device Model NumberG6626746
Device Catalogue NumberG6626746
Device Lot Number76TK
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 03/27/2026
Supplement Date Received by Manufacturer05/05/2026
Initial Report FDA Received Date04/16/2026
Supplement Report FDA Received Date05/25/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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
Outcome Attributed to Adverse Event Required Intervention;
Patient Age73 YR
Patient SexUnknown
Patient Weight50 KG
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