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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 AF02
Medical Device Problem Code Difficult to Insert (1316)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/19/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3: product analysis: evaluation determined that the reported malfunction of the attachment not clamping the cutting blades was conf irmed.The likely cause of the failure was a seized distal bearing.It was also noted that the leg of the attachment was scratched and the color band and laser markings were faded.B3: notified date was considered as the date of event, since the event date was unavailable.G3: aware date used as date of analysis performed date as the event is reported based on evaluation findings.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 did not clamp the cutting blades.There was no patient impact at the time of this report.
 
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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 Key24975158
Report Number1625507-2026-00767
Device Sequence Number20046113
Product Code HBB
UDI-Device Identifier00763000440381
UDI-Public(01)00763000440381(11)240424(20)02
Combination Product (Y/N)N
Initial Reporter CountryPO
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) 04/23/2026
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 NumberAF02
Device Catalogue NumberAF02
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/03/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/16/2026
Initial Report FDA Received Date04/23/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/24/2024
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 Reuse
Patient Sequence Number1
Patient SexUnknown
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