MAUDE Adverse Event Report: ASPEN SURGICAL PRODUCTS, INC. KERRISON RONGEUR, DETACHABLE LUMBAR W/EJECTOR

Model Number	53-1612LD
Medical Device Problem Code	Break (1069)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The device is not available for evaluation.The investigation is ongoing.Once we have additional relevant information it will be submitted in a supplemental report.
Event or Problem Description
Complainant alleges "the tip component consistently breaks at the same point, which has caused repeated failures in clinical use.".
Additional Manufacturer Narrative
The device was not returned for evaluation.Without the device to evaluation, very little investigation could be conducted.The complaint could not be confirmed, and no root cause was determined.If any additional relevant information is identified it will be submitted in a supplemental report.

• Brand Name: KERRISON RONGEUR, DETACHABLE LUMBAR W/EJECTOR
• Common Device Name: KERRISON RONGEUR
• Manufacturer (Section D): ASPEN SURGICAL PRODUCTS, INC.; 6945 southbelt dr se; caledonia MI 49316
• Manufacturer Contact: terry hall ; 6945 southbelt dr se; caledonia, MI 49316 ; 6166987100
• MDR Report Key: 24365894
• Report Number: 3002750084-2026-00011
• Device Sequence Number: 9661175
• Product Code: HAE
• UDI-Device Identifier: 00887482034491
• UDI-Public: 00887482034491
• Combination Product (Y/N): N
• Initial Reporter Country: TU
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Foreign,Distributor
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 03/23/2026

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 Number: 53-1612LD
• Device Lot Number: UNKNOWN
• 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: 01/19/2026
• Supplement Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 02/17/2026
• Supplement Report FDA Received Date: 03/23/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• 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 Number: 1
• Patient Sex: Unknown