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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARTHREX, INC. EXCALIBUR, 4.0MM X 13CM; SAW BLADE

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ARTHREX, INC. EXCALIBUR, 4.0MM X 13CM; SAW BLADE Back to Search Results
Model Number EXCALIBUR, 4.0MM X 13CM
Medical Device Problem Code Material Fragmentation (1261)
Health Effect - Clinical Code Foreign Body In Patient (2687)
Date of Event 02/07/2025
Type of Reportable Event Malfunction
Event or Problem Description
On 02/18/2025, it was reported by an arthrex subsidiary employee via (b)(4) that an ar-8400ex excalibur began to produce debris during use.This was discovered during use in an arthroscopy case.The fragments were unable to be removed.The case was completed using a replacement product.
 
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.Complaint allegation is not confirmed.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 due to excessive prying/leveraging and/or the device coming in contact with another device during use.
 
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Brand Name
EXCALIBUR, 4.0MM X 13CM
Common Device Name
SAW BLADE
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 Key22056041
Report Number1220246-2025-02126
Device Sequence Number17206135
Product Code GFA
UDI-Device Identifier00888867043589
UDI-Public00888867043589
Combination Product (Y/N)N
Initial Reporter CountryKS
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Administrator/Supervisor
Type of Report Initial,Followup
Report Date (Section B) 08/13/2025
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 NumberEXCALIBUR, 4.0MM X 13CM
Device Catalogue NumberAR-8400EX
Device Lot Number15191320
Was Device Available for Evaluation? No
Distributor Facility Aware Date02/18/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/18/2025
Supplement Date Received by Manufacturer08/11/2025
Initial Report FDA Received Date05/20/2025
Supplement Report FDA Received Date08/13/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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