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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARTHREX, INC. NAUTILUS REAMER/DRILL GLOVE PROTECTOR; MANUAL INSTR, GENERAL SURGICAL

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ARTHREX, INC. NAUTILUS REAMER/DRILL GLOVE PROTECTOR; MANUAL INSTR, GENERAL SURGICAL Back to Search Results
Model Number NAUTILUS REAMER/DRILL GLOVE PROTECTOR
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/21/2024
Type of Reportable Event Malfunction
Event or Problem Description
On (b)(6) 2024 , a sales representative reported via (b)(4) that an ar-9510-01 arthrex univers revers¿ version rod and an ar-9216-4 glenoid reamer/drill glove protector broke during use.The case was completed successfully.No pieces broke off inside the patient.This was discovered during a reverse total shoulder arthroplasty procedure on (b)(6) 2024 , with no reported patient harm.Additional information has been requested.
 
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.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.
 
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Brand Name
NAUTILUS REAMER/DRILL GLOVE PROTECTOR
Common Device Name
MANUAL INSTR, GENERAL SURGICAL
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 Key21021296
Report Number1220246-2024-09063
Device Sequence Number21115452
Product Code LXH
UDI-Device Identifier00888867192638
UDI-Public00888867192638
Combination Product (Y/N)N
Initial Reporter StateCO
Initial Reporter CountryUS
PMA/510(K) Number
EXEMPT
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) 07/21/2025
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 NumberNAUTILUS REAMER/DRILL GLOVE PROTECTOR
Device Catalogue NumberAR-9216-4
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/29/2024
Supplement Date Received by Manufacturer06/26/2025
Initial Report FDA Received Date12/26/2024
Supplement Report FDA Received Date07/21/2025
Was Device Evaluated by Manufacturer? (Y/N) No
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 Number1
Patient SexUnknown
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