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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARTHREX, INC. IB KIT, BC, W/ CC FT AND JUMPSTART; BIO SOFT TISSUE FIXATN FASTNR

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ARTHREX, INC. IB KIT, BC, W/ CC FT AND JUMPSTART; BIO SOFT TISSUE FIXATN FASTNR Back to Search Results
Model Number IB KIT, BC, W/ CC FT AND JUMPSTART
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code Foreign Body In Patient (2687)
Date of Event 01/17/2024
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 (b)(6) 2024, a medwatch notification was received via email.A facility representative reported that the guidewire tip from an ar-1788j-cp internalbrace implant system broke in the patient's bone.An anchor was placed in the left ankle, and the guidewire broke proximal to the anchor.The tip was not retrieved.This was discovered during a lateral ankle stabilization procedure on (b)(6) 2024.
 
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 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.
 
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Brand Name
IB KIT, BC, W/ CC FT AND JUMPSTART
Common Device Name
BIO SOFT TISSUE FIXATN FASTNR
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 Key18877512
Report Number1220246-2024-01413
Device Sequence Number9050253
Product Code MAI
UDI-Device Identifier00888867318137
UDI-Public00888867318137
Combination Product (Y/N)N
Initial Reporter StateCT
Initial Reporter CountryUS
PMA/510(K) Number
K101823
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Health Professional,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 05/30/2025
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 NumberIB KIT, BC, W/ CC FT AND JUMPSTART
Device Catalogue NumberAR-1788J-CP
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/22/2024
Supplement Date Received by Manufacturer05/13/2025
Initial Report FDA Received Date03/11/2024
Supplement Report FDA Received Date05/30/2025
Was Device Evaluated by Manufacturer? (Y/N) No
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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