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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MDT POWERED SURGICAL SOLUTIONS MIDAS REX LEGEND; MOTOR, DRILL, PNEUMATIC

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MDT POWERED SURGICAL SOLUTIONS MIDAS REX LEGEND; MOTOR, DRILL, PNEUMATIC Back to Search Results
Model Number AA07
Medical Device Problem Codes Overheating of Device (1437); Loss of Power (1475)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/22/2025
Type of Reportable Event Malfunction
Event or Problem Description
Repair request initiated for device with the report of overheating and device got seized.It was reported that there was no patient involvement.Repair request escalated to a product event due to return in less than 90 days from purchase or repair.
 
Additional Manufacturer Narrative
H3: product analysis:evaluation could not confirm the reported malfunction of overheating the device was tested and the maximum temp erature was measured to be 85°f.It was also noted that laser markings are faded.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.
 
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Brand Name
MIDAS REX LEGEND
Common Device Name
MOTOR, DRILL, PNEUMATIC
Manufacturer (Section D)
MDT POWERED SURGICAL SOLUTIONS
4620 n beach st
fort worth TX 76137
Manufacturer (Section G)
MDT POWERED SURGICAL SOLUTIONS
4620 n beach st
fort worth TX 76137
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key21407813
Report Number1625507-2025-00349
Device Sequence Number13097628
Product Code HBB
UDI-Device Identifier00763000084523
UDI-Public00763000084523
Combination Product (Y/N)N
Initial Reporter CountryIT
PMA/510(K) Number
K020069
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 02/19/2025
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 NumberAA07
Device Catalogue NumberAA07
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/28/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/22/2025
Initial Report FDA Received Date02/19/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/21/2019
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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