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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC SOFAMOR DANEK USA, INC. CD HORIZON® SOLERA® VOYAGER¿ Spinal System; THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM

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MEDTRONIC SOFAMOR DANEK USA, INC. CD HORIZON® SOLERA® VOYAGER¿ Spinal System; THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM Back to Search Results
Model Number 6550017
Medical Device Problem Code Corroded (1131)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/16/2026
Type of Reportable Event Malfunction
Event or Problem Description
Information was received from user facility via a manufacturer representative regarding a extenders used for spinal therapy.It was reported that rust was found on the sides of extender tab.Product was used numerous times.There was no patient involvement reported.There were no further complications reported regarding the event.
 
Additional Manufacturer Narrative
H3: product analysis #(b)(4): part # 6550017 lot# k25l1008 after visual and optical examination, it appears that the etching is worn from normal repeated use and repeated autoclaving.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
CD HORIZON® SOLERA® VOYAGER¿ Spinal System
Common Device Name
THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM
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 Key50894023
Report Number3003120897-2026-01614
Device Sequence Number10759038
Product Code NKB
UDI-Device Identifier00643169754584
UDI-Public(01)00643169754584(11)251110(10)K25L1008
Combination Product (Y/N)N
Initial Reporter StateIN
Initial Reporter CountryUS
PMA/510(K) Number
K170679
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 09/25/2026
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 Health Professional
Device Model Number6550017
Device Catalogue Number6550017
Device Lot NumberK25L1008
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer09/09/2026
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/09/2026
Initial Report FDA Received Date09/25/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/10/2025
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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