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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC NAVIGATION, INC. (LOUISVILLE) OPEN SPINE CLAMP, TITANIUM; NEUROLOGICAL STEREOTAXIC INSTRUMENT
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MEDTRONIC NAVIGATION, INC. (LOUISVILLE) OPEN SPINE CLAMP, TITANIUM; NEUROLOGICAL STEREOTAXIC INSTRUMENT Back to Search Results
Catalog Number 9731780
Device Problems Material Deformation (2976); Naturally Worn (2988)
Patient Problem No Patient Involvement (2645)
Event Date 11/02/2016
Event Type  malfunction  
Manufacturer Narrative
No patient information provided as no patient was involved in this concern.Return requested.Replacement open spine clamp shipped to site 11/07/2016.No parts have been received by manufacturer for analysis.Part not received by manufacturer.
 
Event Description
A site representative reported that their open spine clamp appeared to be worn.The screw for the spine clamp to hold the spine frame shows wear.No further details regarding the damage, or how it occurred, were provided.There was no patient present when this issue was identified.
 
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Brand Name
OPEN SPINE CLAMP, TITANIUM
Type of Device
NEUROLOGICAL STEREOTAXIC INSTRUMENT
Manufacturer (Section D)
MEDTRONIC NAVIGATION, INC. (LOUISVILLE)
826 coal creek circle
louisville CO 80027
Manufacturer (Section G)
MEDTRONIC NAVIGATION, INC. (LOUISVILLE)
826 coal creek circle
louisville CO 80027
Manufacturer Contact
judith ericson
826 coal creek circle
louisville, CO 80027-9710
7208902187
MDR Report Key6136941
MDR Text Key61206149
Report Number1723170-2016-05479
Device Sequence Number1
Product Code HAW
Combination Product (y/n)N
Reporter Country CodeIS
PMA/PMN Number
K990214
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Reporter Occupation Health Professional
Type of Report Initial
Report Date 11/30/2016
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received11/30/2016
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number9731780
Device Lot Number140618
Is the Reporter a Health Professional? Yes
Date Manufacturer Received11/02/2016
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured06/18/2014
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
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