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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 Naturally Worn (2988)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/29/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the attachment has bearing issue prior to the procedure.It was reported that there was no patient involvement.
 
Additional Manufacturer Narrative
H3: product analysis :evaluation determined that the bearing issue was confirmed.The likely cause of the failure is due to corrosion.It was noted also that the difficult to insert tool into the attachment, bearings were broken, spacer found corroded and the burr guide found damaged.This regulatory report is being submitted due to retrospective review through capa 672570.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.
 
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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 Key25484039
Report Number1625507-2026-02594
Device Sequence Number9921760
Product Code HBB
UDI-Device Identifier00763000084738
UDI-Public(01)00763000084738(11)191127
Combination Product (Y/N)N
Initial Reporter CountryIN
PMA/510(K) Number
K020069
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (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) 06/12/2026
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 Manufacturer11/04/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/08/2026
Initial Report FDA Received Date06/12/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/27/2019
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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