MAUDE Adverse Event Report: ARTHREX, INC. GRSPR,MINI,2.75 MM 15°UP CRV W/SR HNDL; MANUAL INSTR, GENERAL SURGICAL

Model Number	GRSPR,MINI,2.75 MM 15°UP CRV W/SR HNDL
Medical Device Problem Codes	Break (1069); Material Twisted/Bent (2981)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	02/06/2025
Type of Reportable Event	Malfunction
Event or Problem Description
On 02/06/2025, it was reported by a sales representative via (b)(4) that an ar-11910sr grspr,mini,2.75 mm 15°up crv w/sr hndl tip was bent and falling apart.This was discovered during the case with no patient harm.
Additional Manufacturer Narrative
Investigation is in process.A follow-up report will be provided upon availability of additional information.
Additional Manufacturer Narrative
Additional information: d9, g3, h3, h6.Complaint allegation is confirmed.Upon visual inspection, it was noted that the tip tube of the mini grasper, straight tip, 15° up curved, self-releasing handle, ø 2.75 mm was bent/broken.Functional testing was not performed due to the broken tip that affected the functionality of all the components of the front-end assembly of the device.The most likely cause for the reported failure can be attributed to user error of the device due to excessive force being used during insecure grasping of tissue and prying/leveraging the device.

• Brand Name: GRSPR,MINI,2.75 MM 15°UP CRV W/SR HNDL
• 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 Key: 21413340
• Report Number: 1220246-2025-00561
• Device Sequence Number: 20891774
• Product Code: NBH
• UDI-Device Identifier: 00888867003859
• UDI-Public: (01)00888867003859(11)230610(10)15102971
• Combination Product (Y/N): N
• Initial Reporter State: MO
• Initial Reporter Country: US
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Distributor
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 03/27/2025

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 Number: GRSPR,MINI,2.75 MM 15°UP CRV W/SR HNDL
• Device Catalogue Number: AR-11910SR
• Device Lot Number: 15102971
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 02/06/2025
• Supplement Date Received by Manufacturer: 03/10/2025
• Initial Report FDA Received Date: 02/19/2025
• Supplement Report FDA Received Date: 03/27/2025
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 06/10/2023
• 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