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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MDT POWERED SURGICAL SOLUTIONS IPC® HANDPIECE ATTACHMENT - INDIGO¿ DRILL; DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE

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MDT POWERED SURGICAL SOLUTIONS IPC® HANDPIECE ATTACHMENT - INDIGO¿ DRILL; DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE Back to Search Results
Model Number 1845020
Device Problem Overheating of Device (1437)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 03/18/2024
Event Type  malfunction  
Event Description
It was reported that during pre-op, the indigo attachment was overheating.There was no patient involvement.
 
Manufacturer Narrative
H3: product analysis stated lock twist found jammed.Bearings were broken and corroded.Output drive shaft assembly was corroded and unable to perform the pre-repair temperature results.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.
 
Manufacturer Narrative
Additional information received shows that there is no information to reasonably suggest that the device in this report may have caused or contributed to a death or serious injury or that the device in this report has malfunctioned.The handpiece was not overheating and the attachment was overheating after 1 minute.Therefore, this event did not and does not meet the reporting criterion.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.
 
Event Description
Additional information was received that the attachment overheating was noticed for more than 1 minute.The procedure was completed by using a competitive drill.The speed was 5000 rpm when the device was being run.The device was being run in the forward mode.The irrigation was used, and the flow rate was 10cc per minute.The handpiece was not overheating.
 
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Brand Name
IPC® HANDPIECE ATTACHMENT - INDIGO¿ DRILL
Type of Device
DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE
Manufacturer (Section D)
MDT POWERED SURGICAL SOLUTIONS
4620 n beach st
fort worth TX 76137
Manufacturer (Section G)
MDT POWERED SURGICAL SOLUTIONS
4620 n beach st
fort worth TX 76137
Manufacturer Contact
glen belmer
6743 southpoint drive north
jacksonville, FL 32216
6122713209
MDR Report Key19103577
MDR Text Key340251078
Report Number1625507-2024-00115
Device Sequence Number1
Product Code HBE
UDI-Device Identifier00763000172879
UDI-Public00763000172879
Combination Product (y/n)N
Reporter Country CodeIN
PMA/PMN Number
K081475
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 05/10/2024
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 Number1845020
Device Catalogue Number1845020
Device Lot Number222179575
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/26/2024
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 03/18/2024
Initial Date FDA Received04/15/2024
Supplement Dates Manufacturer Received04/15/2024
Supplement Dates FDA Received05/10/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured05/25/2021
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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