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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Medtronic Xomed Inc. IPC® HANDPIECE - XPS® STRAIGHTSHOT® M4; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) I

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Medtronic Xomed Inc. IPC® HANDPIECE - XPS® STRAIGHTSHOT® M4; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) I Back to Search Results
Model Number 1898200T
Medical Device Problem Code Vibration (1674)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/03/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during an adenoid surgery, the handpiece vibrated and could not cut tissue normally.The procedure was completed normally after replacement with a backup handpiece.There was no patient impact.
 
Additional Manufacturer Narrative
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
IPC® HANDPIECE - XPS® STRAIGHTSHOT® M4
Common Device Name
DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) I
Manufacturer (Section D)
Medtronic Xomed Inc.
6743 southpoint dr n
jacksonville FL 32216
Manufacturer (Section G)
Medtronic Xomed Inc.
6743 southpoint dr n
jacksonville FL 32216
Manufacturer Contact
justin ellis
6743 southpoint drive north
jacksonville, FL 32216
+1(763)526-5677
MDR Report Key50446054
Report Number1045254-2026-01187
Device Sequence Number10281381
Product Code ERL
UDI-Device Identifier00643169882706
UDI-Public(01)00643169882706(11)250912
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K041413
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 08/26/2026
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 Number1898200T
Device Catalogue Number1898200T
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/03/2026
Initial Report FDA Received Date08/26/2026
Date Device Manufactured09/12/2025
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 SexFemale
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