MAUDE Adverse Event Report: ARTHREX, INC. QUADPRO¿ HARVESTER, 10 MM; PASSER

Model Number	QUADPRO¿ HARVESTER, 10 MM
Medical Device Problem Code	Physical Resistance/Sticking (4012)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	11/30/2023
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
On 12/4/2023, it was reported by a sales representative that an ar-2386-10 quadpro harvester got stuck when trying to cut the graft.The case was completed by opening another ar-2386-10 quadpro harvester.This was discovered during a quad acl procedure on (b)(6), with no reported adverse event or patient harm.Nothing broke inside the patient and there was no reported case delay.
Additional Manufacturer Narrative
Complaint allegation is not confirmed.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 misaligned insertion, prying/leveraging, and/or wrong rotating the harvester during the stripping process.
Event or Problem Description
Additional information received on 12/21/2023: this was discovered during a quad acl procedure on (b)(6), with no reported adverse event or patient harm.Nothing broke inside the patient and there was no reported case delay.

• Brand Name: QUADPRO¿ HARVESTER, 10 MM
• Common Device Name: PASSER
• 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: emily shafer ; 8009337001
• MDR Report Key: 18431406
• Report Number: 1220246-2024-00025
• Device Sequence Number: 18134015
• Product Code: LXH
• UDI-Device Identifier: 00888867344679
• UDI-Public: 00888867344679
• Combination Product (Y/N): N
• Initial Reporter State: MN
• Initial Reporter Country: US
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Distributor
• Initial Reporter Occupation: Administrator/Supervisor
• Type of Report: Initial,Followup
• Report Date (Section B): 01/22/2025

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: QUADPRO¿ HARVESTER, 10 MM
• Device Catalogue Number: AR-2386-10
• Device Lot Number: 22B22
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 12/04/2023
• Supplement Date Received by Manufacturer: 12/27/2024
• Initial Report FDA Received Date: 01/02/2024
• Supplement Report FDA Received Date: 01/22/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 02/01/2022
• 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