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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Medtronic Xomed Inc. XPS® BUR - IPC® M5 AND M4 30K; BUR, EAR, NOSE AND THROAT

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Medtronic Xomed Inc. XPS® BUR - IPC® M5 AND M4 30K; BUR, EAR, NOSE AND THROAT Back to Search Results
Model Number 1884070RTD
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/28/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the burr was damaged upon removal from the sterile packaging and could not be used in the procedure, as it would not fit the m5 microdebrider.A new one had to be opened, which was in perfect condition (like all the others).There is 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
XPS® BUR - IPC® M5 AND M4 30K
Common Device Name
BUR, EAR, NOSE AND THROAT
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 Key50897741
Report Number1045254-2026-01308
Device Sequence Number6001539
Product Code EQJ
UDI-Device Identifier00643169434646
UDI-Public(01)00643169434646(17)270808(10)0231997361
Combination Product (Y/N)N
Initial Reporter CountryMX
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (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) 09/25/2026
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 Number1884070RTD
Device Catalogue Number1884070RTD
Device Lot Number0231997361
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/31/2026
Initial Report FDA Received Date09/25/2026
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 Number1
Patient SexUnknown
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