| Brand Name | MILAGRO |
| Common Device Name | Fastener, fixation, biodegradable, soft tissue |
| Manufacturer (Section D) |
| DePuy Mitek LLC US |
| 325 paramount drive |
| raynham MA 02767 |
|
| Manufacturer Contact |
|
elba
bello
|
| 325 paramount drive |
| raynham, MA 02767
|
|
+1(908)386-3534
|
|
| MDR Report Key | 50794096 |
| Report Number | 1221934-2026-04192 |
| Device Sequence Number | 15833859 |
| Product Code |
MAI
|
| UDI-Device Identifier | 10886705022250 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | CH |
| PMA/510(K) Number | K123362 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,User Facility,Company Representative |
| Type of Report
| Initial |
| Report Date (Section B) |
09/16/2026 |
| 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 Catalogue Number | 231817 |
| Device Lot Number | 1027BA |
| 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 | 09/14/2026 |
| Initial Report FDA Received Date | 09/16/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 07/16/2024 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|