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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC XOMED INC. XPS BUR; BUR, EAR, NOSE AND THROAT

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MEDTRONIC XOMED INC. XPS BUR; BUR, EAR, NOSE AND THROAT Back to Search Results
Model Number 3155637
Device Problem Vibration (1674)
Patient Problems No Consequences Or Impact To Patient (2199); No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/13/2020
Event Type  malfunction  
Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.
 
Event Description
It was reported by a health care professional that all of the drills and burs used by the doctor during the stapedectomy, the device wobbled instead of rotating in a stable fashion.There was no patient impact.Upon follow up it was confirmed that bur was in contact with patient.The device was still used and able to finish the procedure.There were approximately 5 minutes delay in the 45 minutes procedure.
 
Manufacturer Narrative
Medtronic is submitting this report to comply with fda reporting regulations under 21 cfr parts 4 and 803.This report is based upon information obtained by medtronic, which the company may not have been able to fully investigate or verify prior to the date the report was required by the fda.Medtronic has made reasonable efforts to obtain more complete information and has provided 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.In particular, this report does not constitute an admission by anyone that the product described in this report has any ¿defects¿ or has ¿malfunctioned¿.These words are included in the fda 3500a form and are fixed items for selection created by the fda to categorize the type of event solely for the purpose of regulatory reporting.Medtronic objects to the use of these words and others like them because of the lack of definition and the connotations implied by these terms.This statement should be included with any information or report disclosed to the public under the freedom of information act.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.A good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.
 
Event Description
On follow-up it was reported that the bur was seated correctly.It was verified by the sales representative several times, and the surgeon has been using this type of drill for over 15 years.
 
Event Description
Each of the reported burs that wobbled were initial use, not reprocessed, and some wobbled right out of the package.To troubleshoot the issue, the doctor tried using the burs in different handpieces, to see the result.Each of the burs wobbled in a second handpiece; however, it was found that there was variability on how much of a wobble was evident with each handpiece (either more wobble, or less).The facility determined that this was an issue with their handpiece.
 
Manufacturer Narrative
Medtronic is submitting this report to comply with fda reporting regulations under 21 cfr parts 4 and 803.This report is based upon information obtained by medtronic, which the company may not have been able to fully investigate or verify prior to the date the report was required by the fda.Medtronic has made reasonable efforts to obtain more complete information and has provided 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.In particular, this report does not constitute an admission by anyone that the product described in this report has any ¿defects¿ or has ¿malfunctioned¿.These words are included in the fda 3500a form and are fixed items for selection created by the fda to categorize the type of event solely for the purpose of regulatory reporting.Medtronic objects to the use of these words and others like them because of the lack of definition and the connotations implied by these terms.This statement should be included with any information or report disclosed to the public under the freedom of information act.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.A good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.
 
Manufacturer Narrative
H3 the product analysis result indicates that there was no damage to the opened bur, which would have resulted in the reported malfunction.The instruction for use states, ¿bur assembly shall lock into handpiece at 700 rpm using oto-tool console indicator without noticeable wobble, visually 100%¿.The returned sample was placed into the handpiece and ran at 1000 rpm [the console minimum rpm is 1000]; there was no ¿noticeable¿ wobble with an unaided eye.When viewed under magnification, there was no visible damage to the green teflon bushing/sleeve.The bur run at 16,000 rpm and cut saw bone with no issues.There is no geometric dimensioning and tolerancing on the applicable drawings that control the reported wobble [i.E., runout, concentricity, true-position].A review of the global complaint data showed only this facility reporting multiple lots with the same failure mechanism.There was no evidence of improper manufacturing and no fault related to the complaint; therefore, manufacturing ruled out as a potential cause.H6: additional information suggest that fdm b17, fdr c20 are no longer applicable to this event.There were 2 devices used in the surgery and were submitting 2 mdrs for the same event list of products involved: bur 3155637 oto-flex.7mm carbide green lot# 220076449 regulatory rep #: 1045254-2020-00542 drill 3055601 skeeter oto-tool sn# (b)(6) lot# 210345646 regulatory rep #: 1045254-2020-00543.Medtronic is submitting this report to comply with fda reporting regulations under 21 cfr parts 4 and 803.This report is based upon information obtained by medtronic, which the company may not have been able to fully investigate or verify prior to the date the report was required by the fda.Medtronic has made reasonable efforts to obtain more complete information and has provided 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.In particular, this report does not constitute an admission by anyone that the product described in this report has any ¿defects¿ or has ¿malfunctioned¿.These words are included in the fda 3500a form and are fixed items for selection created by the fda to categorize the type of event solely for the purpose of regulatory reporting.Medtronic objects to the use of these words and others like them because of the lack of definition and the connotations implied by these terms.This statement should be included with any information or report disclosed to the public under the freedom of information act.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.A good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.
 
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Brand Name
XPS BUR
Type of Device
BUR, EAR, NOSE AND THROAT
Manufacturer (Section D)
MEDTRONIC XOMED INC.
6743 southpoint dr n
jacksonville FL 32216
MDR Report Key10805436
MDR Text Key215364285
Report Number1045254-2020-00542
Device Sequence Number1
Product Code EQJ
UDI-Device Identifier00681490070492
UDI-Public00681490070492
Combination Product (y/n)N
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Type of Report Initial,Followup,Followup,Followup
Report Date 04/30/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received11/06/2020
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number3155637
Device Catalogue Number3155637
Device Lot Number0220076449
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/27/2021
Date Manufacturer Received04/27/2021
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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