MAUDE Adverse Event Report: MEDTRONIC XOMED INC. XPS® HANDPIECE - MAGNUM® II; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) I

Model Number	1897200
Medical Device Problem Code	Overheating of Device (1437)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/15/2024
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that prior to procedure magnum handpiece had heating issue.It was further stated overheating was noticed with in a minute of usage.The device was run on oscillate mode at 3000rpm.Irrigation was used at the flow rate of 15cc/min.There was no patient involvement.
Additional Manufacturer Narrative
H3: product analysis stated unable to confirm the customer's fault and unable to perform temperature test as blade not rotating.Found the handpiece cosmetically not ok.Connector has dent and collet assembly found corroded.Hi-pot test failed.Motor cable assembly found faulty.Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.

• Brand Name: XPS® HANDPIECE - MAGNUM® II
• Common Device Name: DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) I
• Manufacturer (Section D): MEDTRONIC XOMED INC.; 6743 southpoint dr n; jacksonville FL 32216
• Manufacturer (Section G): MEDTRONIC XOMED INC.; 6743 southpoint dr n; jacksonville FL 32216
• Manufacturer Contact: justin ellis ; 6743 southpoint drive north; jacksonville, FL 32216 ; 7635265677
• MDR Report Key: 20167433
• Report Number: 1045254-2024-01446
• Device Sequence Number: 18205185
• Product Code: ERL
• UDI-Device Identifier: 00643169360846
• UDI-Public: 00643169360846
• Combination Product (Y/N): N
• Initial Reporter Country: IN
• PMA/510(K) Number: K002224
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Foreign,Health Professional,Company Representative
• Initial Reporter Occupation: Biomedical Engineer
• Type of Report: Initial
• Report Date (Section B): 09/09/2024

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: 1897200
• Device Catalogue Number: 1897200
• Device Lot Number: 223439949
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 08/22/2024
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 08/15/2024
• Initial Report FDA Received Date: 09/09/2024
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 12/06/2021
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Reuse
• Patient Sequence Number: 1
• Patient Sex: Unknown