| Brand Name | SPINEJACK EXPANSION KIT 4.2MM |
| Common Device Name | CEMENT, BONE, VERTEBROPLASTY |
| Manufacturer (Section D) |
| STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP |
| 1941 stryker way |
| portage MI 49002 |
|
| Manufacturer (Section G) |
| STRYKER INSTRUMENTS-KALAMAZOO |
| 4100 east milham avenue |
|
| kalamazoo MI 49001 |
|
| Manufacturer Contact |
|
kelsey
barla
|
| 1941 stryker way |
| portage, MI 49002
|
|
2693237700
|
|
| MDR Report Key | 25079954 |
| Report Number | 3015967359-2026-00293 |
| Device Sequence Number | 10418857 |
| Product Code |
NDN
|
| UDI-Device Identifier | 03760253800488 |
| UDI-Public | (01)03760253800488(17)240831(10)18324-220 |
| Combination Product (Y/N) | N |
| Initial Reporter State | HI |
| Initial Reporter Country | US |
| PMA/510(K) Number | K223294 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
User Facility |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
05/05/2026 |
| 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 Catalogue Number | 0909200042 |
| Device Lot Number | 18324-220 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Initial |
| Initial Date Received by Manufacturer | 04/09/2026 |
| Initial Report FDA Received Date | 05/05/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 08/31/2024 |
| 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 |
Concomitant Medical Products and Therapy/Usage Dates | 0406622015 CEMENT, LOT VGF059.; 0909100042 PREP KIT, LOT 18774-10. |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Sex | Unknown |