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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE FG., NANOTACK SUTURE ANCHOR, 1.4MM W/ FLEX INSERTER; FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE

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STRYKER ENDOSCOPY-SAN JOSE FG., NANOTACK SUTURE ANCHOR, 1.4MM W/ FLEX INSERTER; FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE Back to Search Results
Model Number CAT01858
Device Problems Break (1069); Material Deformation (2976)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/22/2023
Event Type  malfunction  
Event Description
It was reported that the anchor broke during procedure.
 
Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
Manufacturer Narrative
Please note that the initial report's type of reportable event was a malfunction for the anchor breaking.However per investigation results, there was no anchor breakage, the anchor was only bent.Therefore this event is not reportable as there was no breaking of the anchor.Alleged failure: during the surgical procedure, all the surgical technique was complied when making the tunnel with a 1.4 bit and its respective guide.After, the nano tack flex anchor was introduced with the suture threads inside the anchor and at the moment of beginning the impact it began to fracture at the tip and to bend and it was not possible to continue inserting the anchor in the hole that had been made with the drill bit and the implant was removed.Another anchorage was used and te same happened.The anchor fractured very easily with impactions with very little force.The failure alleged in the complaint record was not confirmed/duplicated during the product investigation.The probable root causes could be: 1) guide out of specification, 2) use of excessive force, 3) pathology such as schlerotic bone that may thicken the cortical layer.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
Event Description
It was reported that the anchor broke during procedure.Please note that the initial report's type of reportable event was a malfunction for the anchor breaking.However per investigation results, there was no anchor breakage, the anchor was only bent.Therefore this event is not reportable as there was no breaking of the anchor.
 
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Brand Name
FG., NANOTACK SUTURE ANCHOR, 1.4MM W/ FLEX INSERTER
Type of Device
FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE
Manufacturer (Section D)
STRYKER ENDOSCOPY-SAN JOSE
5900 optical court
san jose CA 95138
Manufacturer (Section G)
STRYKER ENDOSCOPY-SAN JOSE
5900 optical court
san jose CA 95138
Manufacturer Contact
lucas wolski
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key16620779
MDR Text Key312073929
Report Number0002936485-2023-00242
Device Sequence Number1
Product Code MBI
UDI-Device Identifier07613252633099
UDI-Public07613252633099
Combination Product (y/n)N
Reporter Country CodeCO
PMA/PMN Number
K131769
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Distributor
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 05/30/2023
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
Device Operator Health Professional
Device Model NumberCAT01858
Device Catalogue NumberCAT01858
Device Lot Number21312AE2
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 03/01/2023
Initial Date FDA Received03/27/2023
Supplement Dates Manufacturer Received03/01/2023
Supplement Dates FDA Received05/30/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured11/08/2021
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Age23 YR
Patient SexMale
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