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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MDT POWERED SURGICAL SOLUTIONS MIDAS REX LEGEND; MOTOR, DRILL, ELECTRIC

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MDT POWERED SURGICAL SOLUTIONS MIDAS REX LEGEND; MOTOR, DRILL, ELECTRIC Back to Search Results
Model Number EM100-A
Medical Device Problem Code Overheating of Device (1437)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/13/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3: no conclusion can be drawn.Device was returned and the evaluation anticipated but not yet begun.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.
 
Event or Problem Description
It was reported that, prior to use and during preparation for a procedure, a motor exhibited heating.It was reported that there was no patient involvement.
 
Additional Manufacturer Narrative
H3:product analysis :an overheating test could not be conducted due to another device malfunction.The likely cause was identified as corrosion and motor failure.It was also noted motor shaft and winding assembly found rusted.Collet shaft assembly found corroded.Error code 15 observed.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
MIDAS REX LEGEND
Common Device Name
MOTOR, DRILL, ELECTRIC
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
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key23484059
Report Number1625507-2025-02263
Device Sequence Number21472452
Product Code HBE
UDI-Device Identifier00763000430887
UDI-Public(01)00763000430887(11)230327(20)03
Combination Product (Y/N)N
Initial Reporter CountryIN
PMA/510(K) Number
K012453
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,Followup
Report Date (Section B) 12/03/2025
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 NumberEM100-A
Device Catalogue NumberEM100-A
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/23/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/14/2025
Supplement Date Received by Manufacturer11/07/2025
Initial Report FDA Received Date11/06/2025
Supplement Report FDA Received Date12/03/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured03/27/2023
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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