| Brand Name | METRx(TM) System |
| Common Device Name | ARTHROSCOPE |
| Manufacturer (Section D) |
| MEDTRONIC SOFAMOR DANEK USA, INC. |
| 4340 swinea rd |
| memphis TN 38118 |
|
| Manufacturer (Section G) |
| MEDTRONIC SOFAMOR DANEK USA, INC. |
| 4340 swinea rd |
|
| memphis TN 38118 |
|
| Manufacturer Contact |
|
justin
ellis
|
| 1800 pyramid place |
| memphis, TN 38132
|
|
+1(763)526-5677
|
|
| MDR Report Key | 50051995 |
| Report Number | 3003120897-2026-01295 |
| Device Sequence Number | 18514255 |
| Product Code |
HRX
|
| UDI-Device Identifier | 00885074210353 |
| UDI-Public | (01)00885074210353(11)230626(10)1861450 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| PMA/510(K) Number | K002931 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
07/28/2026 |
| 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 | 9560100 |
| Device Catalogue Number | 9560100 |
| Device Lot Number | 1861450 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 07/06/2026 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 07/01/2026 |
| Initial Report FDA Received Date | 07/28/2026 |
| Date Device Manufactured | 06/26/2023 |
| 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 |