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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 1845020
Medical Device Problem Code Overheating of Device (1437)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/21/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Continuation of d10: section d information references the main component of the system.Applicable code for unknown handpiece - fdm b17, fdr c20 <(>&<)> img g04063.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 the device was excessively heating.There was no patient impact.
 
Additional Manufacturer Narrative
H3:product # 1845020 analysis could not confirm customer complaint as temperature test could no be performed due to worn and detached distal bearing.Laser marking faded.H6: previously submitted codes fdm b17, fdr c20 and fdc d16 are not longer applicable for product # 1845020.Fdc code d20 is applicable for product number xom unk hpindigo.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 Key23816278
Report Number1625507-2025-02396
Device Sequence Number21325631
Product Code HBE
UDI-Device Identifier00613994933690
UDI-Public(01)00613994933690(11)170911
Combination Product (Y/N)N
Initial Reporter CountryGM
PMA/510(K) Number
K081475
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) 03/13/2026
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 Number1845020
Device Catalogue Number1845020
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/09/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/21/2025
Supplement Date Received by Manufacturer03/10/2026
Initial Report FDA Received Date12/16/2025
Supplement Report FDA Received Date03/13/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/11/2017
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
Usage of Device Reuse
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
"SEE H11...."
Patient SexUnknown
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