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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARTHREX, INC. PEEK, SWIVELOCK FT, 4.75X19.1MM; BIO SOFT TISSUE FIXATN FASTNR

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ARTHREX, INC. PEEK, SWIVELOCK FT, 4.75X19.1MM; BIO SOFT TISSUE FIXATN FASTNR Back to Search Results
Model Number PEEK, SWIVELOCK FT, 4.75X19.1MM
Medical Device Problem Code Material Twisted/Bent (2981)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 08/08/2024
Type of Reportable Event Malfunction
Event or Problem Description
On 8/9/2024, it was reported by a sales representative via email that an ar-1255-18 suture passing wire, nitinol loop portion, snapped in half and an ar-2324pct peek swivelock eyelet bent on anchor.The anchor did not break.Everything was removed from inside the patient.The case was completed using an ar-2324pslc eek-swivelock c.This was discovered during a triceps repair procedure on (b)(6) 2024.The case was delayed a few minutes without additional anesthesia.
 
Additional Manufacturer Narrative
Investigation is in process.A follow-up report will be provided upon availability of additional information.
 
Additional Manufacturer Narrative
Additional information: g3, h3, h6.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 misalignment insertion, and/or prying/leveraging of the device during insertion.
 
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Brand Name
PEEK, SWIVELOCK FT, 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 Key20125382
Report Number1220246-2024-07337
Device Sequence Number3226530
Product Code MAI
UDI-Device Identifier00888867098107
UDI-Public00888867098107
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
K101823
Number of Events Summarized1
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) 07/16/2025
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 NumberPEEK, SWIVELOCK FT, 4.75X19.1MM
Device Catalogue NumberAR-2324PCT
Device Lot Number15117079
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/09/2024
Supplement Date Received by Manufacturer06/24/2025
Initial Report FDA Received Date09/03/2024
Supplement Report FDA Received Date07/16/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/17/2023
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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