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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARTHREX, INC. IMPL SYS,BIO-COMP ACHILLES SPEEDBRG; FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE

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ARTHREX, INC. IMPL SYS,BIO-COMP ACHILLES SPEEDBRG; FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE Back to Search Results
Model Number IMPL SYS,BIO-COMP ACHILLES SPEEDBRG
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/20/2022
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during a surgery the device broke while placing the lateral anchor in heel.The surgery continued since the anchor was enough fixed according to the surgeon.There was no harm for patient, operator or third party reported.It was not necessary to switch the surgical technique or do a second surgery.
 
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.
 
Additional Manufacturer Narrative
Complaint confirmed.One unpackaged ar-8928bc-cp was received for investigation.Visual inspection identified that the distal end of the biocomposite implant had cracked.The method used to prepare the bone, as well as the bone quality encountered, were not provided.The cause remains undetermined.
 
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Brand Name
IMPL SYS,BIO-COMP ACHILLES SPEEDBRG
Common Device Name
FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE
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
vik bajnath
8009337001
MDR Report Key14336488
Report Number1220246-2022-04864
Device Sequence Number4807828
Product Code MAI
UDI-Device Identifier00888867049123
UDI-Public00888867049123
Combination Product (Y/N)N
Initial Reporter CountrySW
PMA/510(K) Number
K101823
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility
Initial Reporter Occupation Nurse
Type of Report Initial,Followup
Report Date (Section B) 06/07/2022
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 Date09/30/2025
Device Model NumberIMPL SYS,BIO-COMP ACHILLES SPEEDBRG
Device Catalogue NumberAR-8928BC-CP
Device Lot Number14325726
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/20/2022
Supplement Date Received by Manufacturer04/20/2022
Initial Report FDA Received Date05/09/2022
Supplement Report FDA Received Date06/07/2022
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured10/13/2021
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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