| Brand Name | EVEREST Spinal System Set Screw ATR¿ |
| Common Device Name | Posterior Cervical Screw System |
| Manufacturer (Section D) |
| K2M, Inc. |
| 600 hope pkwy |
| leesburg VA 20175 |
|
| Manufacturer (Section G) |
| K2M, Inc. |
| 600 hope pkwy se |
|
| leesburg VA 20175 |
|
| Manufacturer Contact |
|
catherine
devarenne
|
| 2 pearl court |
| allendale, NJ 07401
|
|
+1(201)760-8000
|
|
| MDR Report Key | 50060275 |
| Report Number | 3004774118-2026-00215 |
| Device Sequence Number | 9119406 |
| Product Code |
NKG
|
| UDI-Device Identifier | 10888857037939 |
| UDI-Public | 10888857037939 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| PMA/510(K) Number | K181603 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2025 |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Company Representative |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
07/28/2026 |
| 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 | 2901-10001 |
| Device Lot Number | Unknown |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 06/30/2026 |
| Initial Report FDA Received Date | 07/28/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| 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 Age | 71 YR |
| Patient Sex | Unknown |
| Patient Weight | 156 LB |