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U.S. Department of Health and Human Services

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

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CAYENNE MEDICAL QUATTRO LINK ANCHOR 4.5MM SP; FASTENER, FIXATION Back to Search Results
Catalog Number CM-9145SP
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Codes Failure of Implant (1924); No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Customer has indicated that the product is in process of being returned to zimmer biomet for investigation.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event or Problem Description
It was reported during rotator cuff repair surgery, during anchor deployment, the anchor fractured.Attempts have been made and additional information on the reported event is unavailable at this time.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections were updated/corrected.Updated: d9; h2; h3; h6.The reported event is confirmed.Visual inspection confirms that the anchor is broken.Only part of the anchor was returned.Item and lot numbers are not confirmed as they are not etched on the part.The tip of the pulley weldment is bent.Turning the knob does cycle the pully weldment in and out.The device is visually conforming to the print.There are 2 black handle halves and the knob is purple per the print.Medical records were not provided.Device history records were reviewed and no discrepancies related to the reported event were found.Root cause was unable to be determined.If any further information is found which would change or alter any conclusions or information, a supplemental will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
Event or Problem Description
No further event information available at the time of this report.
 
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Brand Name
QUATTRO LINK ANCHOR 4.5MM SP
Common Device Name
FASTENER, FIXATION
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 Key21890975
Report Number3006108336-2025-00014
Device Sequence Number20876568
Product Code MBI
UDI-Device Identifier00887868270208
UDI-Public(01)00887868270208(17)281019(10)66267371
Combination Product (Y/N)N
Initial Reporter CountryIN
PMA/510(K) Number
K122314
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 10/10/2025
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-9145SP
Device Lot Number66267371
Was Device Available for Evaluation? Device Returned to Manufacturer
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 03/25/2025
Supplement Date Received by Manufacturer10/03/2025
Initial Report FDA Received Date04/23/2025
Supplement Report FDA Received Date10/10/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/19/2023
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 Age42 YR
Patient SexMale
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