| Brand Name | IPC® HANDPIECE - INDIGO¿ DRILL |
| Common Device Name | DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE |
| 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 Key | 23473816 |
| Report Number | 1045254-2025-02488 |
| Device Sequence Number | 18765381 |
| Product Code |
HBE
|
| UDI-Device Identifier | 00613994933713 |
| UDI-Public | (01)00613994933713(11)170807 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | CO |
| PMA/510(K) Number | K081475 |
| Number of Events Summarized | 1 |
| 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) |
11/05/2025 |
| 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 | 1845000 |
| Device Catalogue Number | 1845000 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Date Returned to Manufacturer | 10/09/2025 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 10/09/2025 |
| Initial Report FDA Received Date | 11/05/2025 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 08/07/2017 |
| 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
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |