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U.S. Department of Health and Human Services

Class 2 Device Recall ATLANTIS(R) Anterior Cervical Plate System VARIABLE ANGLE SCREW MODULE

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  Class 2 Device Recall ATLANTIS(R) Anterior Cervical Plate System VARIABLE ANGLE SCREW MODULE see related information
Date Initiated by Firm August 30, 2012
Date Posted October 10, 2012
Recall Status1 Terminated 3 on August 15, 2013
Recall Number Z-0036-2013
Recall Event ID 63157
510(K)Number K081038  K063100  K021461  
Product Classification Appliance, fixation, spinal intervertebral body - Product Code KWQ
Product ATLANTIS(R) Anterior Cervical Plate System VARIABLE ANGLE SCREW MODULE, REF 176-503, QTY: 1 EA, Rx only, Medtronic Sofamore Danek USA, Inc., 1800 Pyramid Place, Memphis, Tennessee 38132.

Orthopedic.
This instrument is a precision device which may incorporate a measuring function and has uses as described on the label. Unless labeled for
single use, this instrument may be re-used.
Code Information All lots except those starting with SY
Recalling Firm/
Manufacturer		 Medtronic Sofamor Danek USA Inc
1800 Pyramid Place
Memphis TN 38132
For Additional Information Contact Rita Tate
901-396-3010
Manufacturer Reason
for Recall		 Lines on the screw gauge may not placed on the caddy properly which could result in improper measurement of screws. An incorrect gauge could measure a screw to be approximately 1 mm shorter than its actual length.
FDA Determined
Cause 2		 Nonconforming Material/Component
Action Medtronic conducted a conference call on August 30, 2012 and sent an "URGENT VOLUNTARY RECALL" notice dated September 3, 2012 to all affected customers. The notice identified the product, problem, and actions to be taken by the customers. A Recall Questionnaire Form was attached to the letter for customers to complete and return. Contact your Medtronic Sales representative or the firm's Global Quality Department at 800-876-3133, ext. 3197 for questions regarding this notice.
Quantity in Commerce 1047 units
Distribution Worldwide Distribution-USA (nationwide) and the countries of India, Netherlands, Hong Kong, S. L Korea, Singapore, Canada, Australia, Japan, and Mexico.
Total Product Life Cycle TPLC Device Report
1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
3 For details about termination of a recall see Code of Federal Regulations (CFR) Title 21 §7.55.
510(K) Database 510(K)s with Product Code = KWQ and Original Applicant = MEDTRONIC SOFAMOR DANEK
510(K)s with Product Code = KWQ and Original Applicant = MEDTRONIC SOFAMOR DANEK, INC.
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