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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MSD Deggendorf Mfg Clydesdale¿ Spinal System; INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT,

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MSD Deggendorf Mfg Clydesdale¿ Spinal System; INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, Back to Search Results
Model Number 2922445
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/02/2026
Type of Reportable Event Malfunction
Event or Problem Description
Information was received from healthcare provider (hcp) via a manufacturer representative regarding a patient having oblique lateral interbody fusion due to herniated disc disease.It was reported that during the procedure while inserting, cages broke.There was no patient symptom reported.There were no further complications reported regarding the event.
 
Additional Manufacturer Narrative
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
Clydesdale¿ Spinal System
Common Device Name
INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT,
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
+1(763)526-5677
MDR Report Key50881099
Report Number3011795235-2026-00063
Device Sequence Number16128527
Product Code MAX
UDI-Device Identifier00613994972453
Combination Product (Y/N)N
Initial Reporter CountryIN
PMA/510(K) Number
K113528
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
Device Explanted Year2026
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) 09/24/2026
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 Number2922445
Device Catalogue Number2922445
Device Lot Number06PU
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 09/03/2026
Initial Report FDA Received Date09/24/2026
Date Device Manufactured10/02/2023
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
Patient Age70 YR
Patient SexFemale
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