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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDOS INTERNATIONAL SàRL 4K EPSCP SCP,4.0,30,167,MITEK; ARTHROSCOPE

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MEDOS INTERNATIONAL SàRL 4K EPSCP SCP,4.0,30,167,MITEK; ARTHROSCOPE Back to Search Results
Catalog Number 242137
Medical Device Problem Code Display or Visual Feedback Problem (1184)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/17/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that after surgery the 4k epscp scp,4.0,30,167,mitek device optics produced a blurry view.There were no delays to surgery.There were no reports of injuries, medical intervention or prolonged hospitalization.All available information has been disclosed.
 
Additional Manufacturer Narrative
This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by depuy synthes, or its employees that the report constitutes an admission that the product, depuy synthes, 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 report, a follow-up report will be filed as appropriate.H11: additional narrative: investigation summary the complaint device was not returned to depuy synthes, therefore unavailable for a physical evaluation.A manufacturing record evaluation was performed for the finished device serial number (b)(6), and no non-conformance was identified.Based on the current available information, we cannot determine a root cause for the reported failure.If the complaint device 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
4K EPSCP SCP,4.0,30,167,MITEK
Common Device Name
ARTHROSCOPE
Manufacturer (Section D)
MEDOS INTERNATIONAL SàRL
chemin-blanc 38
le locle 02400
SZ  02400
Manufacturer (Section G)
MEDOS INTERNATIONAL SARL
chemin blanc 38
le locle CH-24 00
SZ   CH-2400
Manufacturer Contact
elba bello
325 paramount drive
raynham, MA 02767
9083863534
MDR Report Key24433682
Report Number1221934-2026-00875
Device Sequence Number10254050
Product Code HRX
UDI-Device Identifier10886705031993
UDI-Public(01)10886705031993
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K080560
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 02/24/2026
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 Catalogue Number242137
Device Lot Number1959256
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/17/2026
Initial Report FDA Received Date02/24/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/30/2024
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 Unknown
Patient Sequence Number1
Patient SexUnknown
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