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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC SOFAMOR DANEK USA, INC. METRX II; ORTHOPEDIC MANUAL SURGICAL INSTRUMENT

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MEDTRONIC SOFAMOR DANEK USA, INC. METRX II; ORTHOPEDIC MANUAL SURGICAL INSTRUMENT Back to Search Results
Model Number 9560524
Medical Device Problem Code Mechanics Altered (2984)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/27/2026
Type of Reportable Event Malfunction
Event or Problem Description
Information was received from healthcare provider (hcp) via a manufacturer representative regarding a patient having microendoscopic discectomy.It was reported that the fixing screw was rotated, it could not be fixed to the post, and handle does not rotate.Also the camera part at the tip is reported to be loose.There was no patient symptom reported.The patient was present at the time of the event, but since it was discovered during procedure preparation, there was no impact on the patient.There were no further complications reported regarding the event.
 
Additional Manufacturer Narrative
H3: product analysis - product: 9560524, lot no: my23e002 during the incoming inspection, deformation of the threads of the handle screw and looseness of the holder were observed.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.
 
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Brand Name
METRX II
Common Device Name
ORTHOPEDIC MANUAL SURGICAL INSTRUMENT
Manufacturer (Section D)
MEDTRONIC SOFAMOR DANEK USA, INC.
4340 swinea rd
memphis TN 38118
Manufacturer (Section G)
MEDTRONIC SOFAMOR DANEK USA, INC.
4340 swinea rd
memphis TN 38118
Manufacturer Contact
justin ellis
1800 pyramid place
memphis, TN 38132
+1(763)526-5677
MDR Report Key50845725
Report Number3003120897-2026-01593
Device Sequence Number10236167
Product Code LXH
UDI-Device Identifier00721902322556
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
Exempt
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 09/22/2026
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 Number9560524
Device Catalogue Number9560524
Device Lot NumberMY23E002
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer09/01/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/27/2026
Initial Report FDA Received Date09/21/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/02/2023
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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