MAUDE Adverse Event Report: ARTHREX, INC. BIOCOMPOSITE 2.4MM MINI HIP PUSHLOCK; BIO SOFT TISSUE FIXATN FASTNR

Model Number BIOCOMPOSITE 2.4MM MINI HIP PUSHLOCK

Device Problem Device Dislodged or Dislocated (2923)

Patient Problem Insufficient Information (4580)

Event Date 12/04/2023

Event Type  malfunction  

Manufacturer Narrative

The contribution of the device to the reported event could not be determined as the device was not returned for evaluation.The root cause of the event could not be determined from the information available and without device evaluation.If the device becomes available for evaluation, a follow-up report will be submitted.

Event Description

On 12/4/2023, it was reported by a distributor via (b)(4) that an ar-2924bch biocomposite 2.4mm mini hip pushlock pulled out.This was discovered during a hip labrum procedure on (b)(6) 2023.Two other mini hip pushlock worked fine but the third pulled out.

• Brand Name: BIOCOMPOSITE 2.4MM MINI HIP PUSHLOCK
• Type of Device: BIO SOFT TISSUE FIXATN FASTNR
• Manufacturer (Section D): ARTHREX, INC.; 1370 creekside boulevard; naples FL 34108 1945
• Manufacturer (Section G): ARTHREX, INC.; 1370 creekside boulevard; naples FL 34108 1945
• Manufacturer Contact: emily shafer ; 8009337001
• MDR Report Key: 18424776
• MDR Text Key: 332607668
• Report Number: 1220246-2024-09785
• Device Sequence Number: 1
• Product Code: MAI
• UDI-Device Identifier: 10888867311302
• UDI-Public: 10888867311302
• Combination Product (y/n): N
• Reporter Country Code: CA
• PMA/PMN Number: K201786
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Foreign,Distributor
• Reporter Occupation: Administrator/Supervisor
• Type of Report: Initial
• Report Date: 01/02/2024

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 Number: BIOCOMPOSITE 2.4MM MINI HIP PUSHLOCK
• Device Catalogue Number: AR-2924BCH
• Device Lot Number: 15087370
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 12/04/2023
• Initial Date FDA Received: 01/02/2024
• Was Device Evaluated by Manufacturer?: No
• Date Device Manufactured: 05/02/2023
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1