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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC XOMED INC. IPC® HANDPIECE - INDIGO¿ DRILL; DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE

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MEDTRONIC XOMED INC. IPC® HANDPIECE - INDIGO¿ DRILL; DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE Back to Search Results
Model Number 1845000
Device Problem Overheating of Device (1437)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 03/22/2024
Event Type  malfunction  
Manufacturer Narrative
H3: analysis results were not available as of the date of this report.A follow-up report will be submitted when analysis is complete.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
It was reported that during pre op the indigo drill was getting heated in less than a minute.The device was being run at 75000 rpm in forward.Manual irrigation was used.The procedure was completed by mr8 device.There was no patient involved.
 
Manufacturer Narrative
Product analysis found that unable to confirm the reported fault of heating.Unable to perform temperature test as connector found damaged and the collet assembly found corroded.Codes are updated.Previously applied fdm b21, fdr c21, fdc d16 and img g04063 codes no longer applicable.Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant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.
 
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Brand Name
IPC® HANDPIECE - INDIGO¿ DRILL
Type of Device
DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE
Manufacturer (Section D)
MEDTRONIC XOMED INC.
6743 southpoint dr n
jacksonville FL 32216
Manufacturer (Section G)
MEDTRONIC XOMED INC.
6743 southpoint dr n
jacksonville FL 32216
Manufacturer Contact
glen belmer
6743 southpoint drive north
jacksonville, FL 32216
6122713209
MDR Report Key19123710
MDR Text Key340402140
Report Number1045254-2024-00565
Device Sequence Number1
Product Code HBE
UDI-Device Identifier00613994933713
UDI-Public00613994933713
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 05/15/2024
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 Number1845000
Device Catalogue Number1845000
Device Lot Number206765042
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/28/2024
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 03/22/2024
Initial Date FDA Received04/17/2024
Supplement Dates Manufacturer Received04/20/2024
Supplement Dates FDA Received05/15/2024
Was Device Evaluated by Manufacturer? No
Date Device Manufactured03/01/2013
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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