| Brand Name | VIRAGE POLYAXIAL SCREW, 3.5 X 28MM |
| Common Device Name | APPLIANCE, FIXATION, SPINAL INTERLAMINAL |
| Manufacturer (Section D) |
| ZIMMER BIOMET SPINE, INC. |
| 10225 westmoor dr. |
| westminster CO 80021 |
|
| Manufacturer (Section G) |
| ZIMMER BIOMET SPINE, INC. |
| 10225 westmoor dr. |
|
| westminster CO 80021 |
|
| Manufacturer Contact |
|
teresa
george
|
| 10225 westmoor dr. |
| westminster, CO 80021
|
|
3035018506
|
|
| MDR Report Key | 25289595 |
| Report Number | 3012447612-2026-00142 |
| Device Sequence Number | 15976230 |
| Product Code |
KWP
|
| UDI-Device Identifier | 00889024327146 |
| UDI-Public | (01)00889024327146(10)AWX |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| PMA/510(K) Number | K133556 |
| Exemption Number | 5645646 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,Company Representative |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| 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? |
No
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Lay User/Patient
|
| Device Catalogue Number | 07.01702.021 |
| Device Lot Number | AWX |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Initial |
| Initial Date Received by Manufacturer | Not provided |
| Initial Report FDA Received Date | 05/26/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 07/29/2025 |
| 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 Number | 1 |
| Patient Age | 55 YR |
| Patient Sex | Male |
| Patient Ethnicity | Non Hispanic |
| Patient Race | Asian |
|
|