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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY MITEK LLC US MILAGRO ADVANCE SCREW 7X23MM; FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE

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DEPUY MITEK LLC US MILAGRO ADVANCE SCREW 7X23MM; FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE Back to Search Results
Catalog Number 231816
Medical Device Problem Codes Break (1069); Device-Device Incompatibility (2919); Mechanical Jam (2983)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/15/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during a long head of biceps (lhb) fixation on the shoulder, after attaching the milagro advance screw 7x23mm device to the 23mm large milagro driver and inserting it into the bone tunnel, an issue occurred where the driver became stuck and could not be removed from the screw device.The surgeon removed the milagro screw and driver from the bone tunnel and attempted to remove it from the driver outside the body, but it was stuck tightly and could not be moved, so he broke the milagro and removed it from the driver.A new device of the same size was used.There was no residue remaining inside the body.There was no surgical delay and no harm to the patient.No additional information could be provided.
 
Additional Manufacturer Narrative
This report is being submitted in pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by mitek or its employees that the report constitutes an admission that the device, mitek, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.Device was used for treatment, not diagnosis.H11 additional narrative: as of this date, the device has not been returned for evaluation; therefore, the reported condition cannot be confirmed and/or duplicated.
 
Additional Manufacturer Narrative
This report is being submitted in pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by mitek or its employees that the report constitutes an admission that the device, mitek, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.Device was used for treatment, not diagnosis.H11 additional narrative: investigation summary: the complaint device was discarded by the customer, therefore not returned to depuy synthes and unavailable for a physical evaluation.A manufacturing record evaluation was performed for the finished device lot number, and no non-conformance was identified.Based on the current available information, we cannot determine a root cause for the reported failure.If additional information is received in the future, we will reopen the complaint and perform the investigation as appropriate.It has been determined that no corrective and/or preventative action is proposed and there is no indication that a design or manufacturing issue has caused the reported complaint condition.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.
 
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Brand Name
MILAGRO ADVANCE SCREW 7X23MM
Common Device Name
FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE
Manufacturer (Section D)
DEPUY MITEK LLC US
325 paramount drive
raynham MA 02767
Manufacturer Contact
elba bello
325 paramount drive
raynham, MA 02767
9083863534
MDR Report Key23856570
Report Number1221934-2025-04899
Device Sequence Number20116007
Product Code MAI
UDI-Device Identifier10886705022243
UDI-Public(01)10886705022243(10)1019P6(17)270430
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K143660
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,User Facility,Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
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 Catalogue Number231816
Device Lot Number1019P6
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/15/2025
Supplement Date Received by Manufacturer12/25/2025
Initial Report FDA Received Date12/19/2025
Supplement Report FDA Received Date01/05/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured05/28/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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