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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MDT POWERED SURGICAL SOLUTIONS IPC® HANDPIECE ATTACHMENT - INDIGO¿ DRILL; DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE

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MDT POWERED SURGICAL SOLUTIONS IPC® HANDPIECE ATTACHMENT - INDIGO¿ DRILL; DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE Back to Search Results
Model Number 1845010
Medical Device Problem Codes Overheating of Device (1437); Noise, Audible (3273)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/20/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that prior to use, the indigo attachment was heating and bubbling.The device experienced overheating in less than one minute.The device was operated in forward mode with an irrigation flow rate of 30cc.There was no patient involvement.
 
Additional Manufacturer Narrative
H3: product analysis found not able to confirm reported fault.Bearings are broken.Bearings are corroded.Not able to perform pre-repair temperature test due to corrosion.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
IPC® HANDPIECE ATTACHMENT - INDIGO¿ DRILL
Common Device Name
DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE
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
6743 southpoint drive north
jacksonville, FL 32216
7635265677
MDR Report Key23070021
Report Number1625507-2025-02072
Device Sequence Number10065075
Product Code HBE
UDI-Device Identifier00763000172862
UDI-Public(01)00763000172862(11)201027
Combination Product (Y/N)N
Initial Reporter CountryIN
PMA/510(K) Number
K081475
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative,Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 09/17/2025
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 Number1845010
Device Catalogue Number1845010
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/12/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/20/2025
Initial Report FDA Received Date09/17/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/27/2020
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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