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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARTHREX, INC. DISPOSABLES KIT, FOR FIBERTAK,STRAIGHT; POWERED SURG ORTHOPEDIC INSTR

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ARTHREX, INC. DISPOSABLES KIT, FOR FIBERTAK,STRAIGHT; POWERED SURG ORTHOPEDIC INSTR Back to Search Results
Model Number DISPOSABLES KIT, FOR FIBERTAK,STRAIGHT
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/14/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during an anterior labrum repair surgery the drill bit broke off in the glenoid bone inside the patient.The broken pieces were retrieved from patient.There was no harm for patient, operator or third party reported.The surgery was finished successfully with a bigger drill (1.8mm).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
Additional information: g3, h3, h6.Based on the information provided, which may include the device (if available and returned), pictures, videos, event descriptions, and any additional information from the field, arthrex concluded that the most likely cause.The most likely cause of the reported failure is user error, specifically, misaligning the insertion.The complaint allegation was not confirmed.The device was not received for evaluation, and no evidence of the failure was provided.
 
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Brand Name
DISPOSABLES KIT, FOR FIBERTAK,STRAIGHT
Common Device Name
POWERED SURG ORTHOPEDIC INSTR
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
jared engle
8009337001
MDR Report Key18816993
Report Number1220246-2024-01239
Device Sequence Number8308210
Product Code HWE
UDI-Device Identifier00888867239128
UDI-Public00888867239128
Combination Product (Y/N)N
Initial Reporter CountrySF
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,Followup
Report Date (Section B) 06/04/2025
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 NumberDISPOSABLES KIT, FOR FIBERTAK,STRAIGHT
Device Catalogue NumberAR-3600D
Device Lot Number15035836
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/14/2024
Supplement Date Received by Manufacturer05/15/2025
Initial Report FDA Received Date03/01/2024
Supplement Report FDA Received Date06/04/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/19/2022
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 Number1
Patient SexUnknown
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