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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: CAYENNE MEDICAL QUATTRO LINK ANCHOR 4.5MM; FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE

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CAYENNE MEDICAL QUATTRO LINK ANCHOR 4.5MM; FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE Back to Search Results
Catalog Number CM-9145
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/30/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).G2: foreign: germany the product will not be returned to zimmer biomet for investigation, as the product has been discarded.The investigation is in process.Upon completion of the investigation, a follow-up mdr will be submitted.
 
Event or Problem Description
It was reported that during an initial fixation procedure, the anchor device fractured while being inserted into the bone.There was a ten (10) minute surgical delay to retrieve a new anchor and the broken fragments however no patient impact or adverse events have been reported as a result of the malfunction.It was reported that no further information is available.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Visual and dimensional evaluations of the product could not be performed as no product was returned nor were pictures provided.Device history record was reviewed and no discrepancies related to the reported event were found.Root cause was unable to be determined.Reported event was unable to be confirmed.If any further information is found which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
Event or Problem Description
No further event information at time of this report.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections have been updated/corrected: b4; b5; g3; h2; h11.Visual examination of the provided photo identified that the anchor is on the inserter.The anchor is fractured at the eyelet and a piece is missing.Further visual and dimensional evaluations could not be performed as no product was returned nor additional photos provided.Device history record was reviewed and no discrepancies related to the reported event were found.Root cause was unable to be determined.Reported event was confirmed by provided photograph.If any further information is found which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
Event or Problem Description
No further event information at time of this report.
 
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Brand Name
QUATTRO LINK ANCHOR 4.5MM
Common Device Name
FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE
Manufacturer (Section D)
CAYENNE MEDICAL
16597 n 92nd street
scottsdale AZ 85260
Manufacturer (Section G)
CAYENNE MEDICAL
16597 n 92nd street
scottsdale AZ 85260
Manufacturer Contact
jennifer rapsavage
56 e. bell dr
warsaw, IN 46582
5745260384
MDR Report Key20677756
Report Number3006108336-2024-00035
Device Sequence Number12992645
Product Code MBI
UDI-Device Identifier00887868270192
UDI-Public(01)00887868270192(17)290409(10)66700044
Combination Product (Y/N)N
Initial Reporter CountryGM
PMA/510(K) Number
K122314
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date (Section B) 11/25/2025
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 Catalogue NumberCM-9145
Device Lot Number66700044
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/07/2024
Supplement Date Received by Manufacturer02/07/2025
10/31/2025
Initial Report FDA Received Date11/13/2024
Supplement Report FDA Received Date02/18/2025
11/25/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/09/2024
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 Age33 YR
Patient SexMale
Patient Weight87 KG
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