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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, PNEUMATIC

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MDT POWERED SURGICAL SOLUTIONS MIDAS REX LEGEND; MOTOR, DRILL, PNEUMATIC Back to Search Results
Model Number AS08
Medical Device Problem Code No Apparent Adverse Event (3189)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/23/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3:product analysis :evaluation determined that the attachment was not working.The likely cause of the failure is the distal bearings is detached.It was also noted that the tube spacers are worn, washer is bent and the color band has lost its correct color tone.G3:aware date used as date of analysis performed date as the event is reported based on evaluation findings.This regulatory report is being submitted due to retrospective review through capa #672570 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 attachment has a generic issue.It was reported that there was no patinet involvement.Additional information received stated that the distal bearings got detached.
 
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Brand Name
MIDAS REX LEGEND
Common Device Name
MOTOR, DRILL, PNEUMATIC
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 Key24764033
Report Number1625507-2026-00419
Device Sequence Number18478891
Product Code HBB
UDI-Device Identifier00763000084790
UDI-Public(01)00763000084790(11)190322
Combination Product (Y/N)N
Initial Reporter CountryIT
PMA/510(K) Number
K020069
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
Report Date (Section B) 04/02/2026
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 NumberAS08
Device Catalogue NumberAS08
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/26/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/30/2026
Initial Report FDA Received Date04/02/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/22/2019
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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