MAUDE Adverse Event Report: ARTHREX, INC. #2 FW W/TPR NDL 36.6MM 1/2 CIRCLE; POLYETHYLENE SYNTHETIC SUTURE

Model Number	#2 FW W/TPR NDL 36.6MM 1/2 CIRCLE
Medical Device Problem Code	Break (1069)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	05/09/2023
Type of Reportable Event	Malfunction
Event or Problem Description
On 05/09/2023, it was reported by a sales representative via sems that an ar-7206 fiberwire needle is breaking.This was discovered during a case, device breaks during use.Per facility: "uses the wire when closing capsule after total hip, and the needle keeps breaking.Dr.Freeman has been experiencing this issue with multiple of the fiber wire needles in various cases.No harm to patient, broken needles are discarded, and new ones are used to finish the case.".
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
Based on the information provided which may include the device (if available and returned), pictures, videos, event description, and any additional information from the field, arthrex was able to conclude a most likely cause.The most likely cause for the reported failure can be attributed to user error of the device due to excessive force used during suture passing.

• Brand Name: #2 FW W/TPR NDL 36.6MM 1/2 CIRCLE
• Common Device Name: POLYETHYLENE SYNTHETIC SUTURE
• 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 Key: 17053362
• Report Number: 1220246-2023-06830
• Device Sequence Number: 3376980
• Product Code: GAT
• UDI-Device Identifier: 00888867041349
• UDI-Public: 00888867041349
• Combination Product (Y/N): N
• Initial Reporter State: TN
• Initial Reporter Country: US
• PMA/510(K) Number: K122374
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Distributor
• Initial Reporter Occupation: Administrator/Supervisor
• Type of Report: Initial,Followup
• Report Date (Section B): 10/16/2024

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
• Operator of Device: Health Professional
• Device Model Number: #2 FW W/TPR NDL 36.6MM 1/2 CIRCLE
• Device Catalogue Number: AR-7206
• Was Device Available for Evaluation?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 05/09/2023
• Supplement Date Received by Manufacturer: 10/08/2024
• Initial Report FDA Received Date: 06/02/2023
• Supplement Report FDA Received Date: 10/16/2024
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Sex: Unknown