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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC XOMED INC. IPC® HANDPIECE - XPS® STRAIGHTSHOT® M4; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) I

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MEDTRONIC XOMED INC. IPC® HANDPIECE - XPS® STRAIGHTSHOT® M4; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) I Back to Search Results
Model Number 1898200T
Medical Device Problem Codes Overheating of Device (1437); Use of Device Problem (1670)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/21/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3: product analysis found that unable to confirm the reported fault of heating as motor was not rotating.Found the handpiece cosmetically not ok.Connector has dent.Hi-pot test fail.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.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
It was reported that pre-op, the m4 handpiece was overheating within a minute in forward mode at speed of 6000r pm and irrigation used at 15cc/min.It was not working.There was no patient involvement.
 
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Brand Name
IPC® HANDPIECE - XPS® STRAIGHTSHOT® M4
Common Device Name
DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) I
Manufacturer (Section D)
MEDTRONIC XOMED INC.
6743 southpoint dr n
jacksonville FL 32216
Manufacturer (Section G)
MEDTRONIC XOMED INC.
6743 southpoint dr n
jacksonville FL 32216
Manufacturer Contact
justin ellis
6743 southpoint drive north
jacksonville, FL 32216
7635265677
MDR Report Key22036589
Report Number1045254-2025-01357
Device Sequence Number8415171
Product Code ERL
UDI-Device Identifier00885074080932
UDI-Public00885074080932
Combination Product (Y/N)N
Initial Reporter CountryIN
PMA/510(K) Number
K041413
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) 05/16/2025
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 Number1898200T
Device Catalogue Number1898200T
Device Lot Number207918662
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/05/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/23/2025
Initial Report FDA Received Date05/16/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/14/2014
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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