MAUDE Adverse Event Report: ARTHREX, INC. SWVLK TENO BIO-COMP 7X 19.5MM; FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE

Model Number	SWVLK TENO BIO-COMP 7X 19.5MM
Health Effect - Clinical Code	Insufficient Information (4580)
Date of Event	07/13/2021
Type of Reportable Event	Malfunction
Additional 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 or Problem Description
It was reported that a bio-composite tenodesis swivelock, ar-1662bc-7, was being used during a posterior meniscal procedure.Upon tapping the swivelock into the hole, the fork tip broke off.The implant was removed and the tip retrieved from the patient.A second bio-composite tenodesis swivelock, ar-1662bc-7, was used to complete the case without further incident.

• Brand Name: SWVLK TENO BIO-COMP 7X 19.5MM
• Common Device Name: FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE
• Manufacturer (Section D): ARTHREX, INC.; 1370 creekside boulevard; naples FL 34108 1945
• MDR Report Key: 12362247
• Report Number: 1220246-2021-03550
• Device Sequence Number: 3536649
• Product Code: MAI
• UDI-Device Identifier: 00888867020573
• UDI-Public: 00888867020573
• Combination Product (Y/N): N
• Initial Reporter Country: PE
• PMA/510(K) Number: K101823
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: distributor,foreign
• Initial Reporter Occupation: Administrator/Supervisor
• Type of Report: Initial
• Report Date (Section B): 08/24/2021

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
• Operator of Device: Health Professional
• Device Expiration Date: 07/31/2024
• Device Model Number: SWVLK TENO BIO-COMP 7X 19.5MM
• Device Catalogue Number: AR-1662BC-7
• Device Lot Number: 11607922
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 08/04/2021
• Initial Report FDA Received Date: 08/24/2021
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1