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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARTHREX, INC. TORPEDO, 5.0MM X 13 CM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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ARTHREX, INC. TORPEDO, 5.0MM X 13 CM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Model Number TORPEDO, 5.0MM X 13 CM
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 11/28/2022
Type of Reportable Event Malfunction
Event or Problem Description
On (b)(6) 2022, it was reported by a sales rep via email that an ar-8500td, torpedo, 5.0mm x 13 cm broke whilst using in the patient.It was a 5mm one and apparently it broke at the internal shaft.This was discovered during use and a case was involved.To complete the procedure, an alternate shaver was used.
 
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.
 
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Brand Name
TORPEDO, 5.0MM X 13 CM
Common Device Name
BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL
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 Key15958893
Report Number1220246-2022-05916
Device Sequence Number4938573
Product Code GFA
UDI-Device Identifier10888867043920
UDI-Public00888867043923
Combination Product (Y/N)N
Initial Reporter CountryAS
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Administrator/Supervisor
Type of Report Initial
Report Date (Section B) 12/12/2022
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 Model NumberTORPEDO, 5.0MM X 13 CM
Device Catalogue NumberAR-8500TD
Device Lot Number10633881
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/29/2022
Initial Report FDA Received Date12/12/2022
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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