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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARTHREX, INC. BIO-COMP SWVLK C, CLD 4.75X19.1MM; BIO SOFT TISSUE FIXATN FASTNR

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ARTHREX, INC. BIO-COMP SWVLK C, CLD 4.75X19.1MM; BIO SOFT TISSUE FIXATN FASTNR Back to Search Results
Model Number BIO-COMP SWVLK C, CLD 4.75X19.1MM
Medical Device Problem Code Break (1069)
Health Effect - Clinical Codes Foreign Body In Patient (2687); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/24/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during an acl surgery the implant broke while screwing into the pre-drilled hole.There was no harm for patient, operator or third party.The surgery was finished successfully with a new device with the same part number.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 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 improper bone prep; misaligned insertion; prying/leveraging the device during insertion.
 
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Brand Name
BIO-COMP SWVLK C, CLD 4.75X19.1MM
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 Key19623852
Report Number1220246-2024-06458
Device Sequence Number6359453
Product Code MAI
UDI-Device Identifier00888867097988
UDI-Public00888867097988
Combination Product (Y/N)N
Initial Reporter CountryPL
PMA/510(K) Number
K203495
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) 07/01/2025
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 NumberBIO-COMP SWVLK C, CLD 4.75X19.1MM
Device Catalogue NumberAR-2324BCC-1
Device Lot Number15193163
Was Device Available for Evaluation? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/07/2024
Supplement Date Received by Manufacturer06/06/2025
Initial Report FDA Received Date06/27/2024
Supplement Report FDA Received Date07/01/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/15/2024
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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