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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MDT Powered Surgical Solutions LEGEND STRAIGHT ATTACHMENT; MOTOR, DRILL, PNEUMATIC

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MDT Powered Surgical Solutions LEGEND STRAIGHT ATTACHMENT; MOTOR, DRILL, PNEUMATIC Back to Search Results
Model Number AS10S
Medical Device Problem Code Difficult to Insert (1316)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/24/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H3: product analysis: evaluation determined that the cutter head cannot be inserted.The likely cause of failure was due to bearing (distal) are detached.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.
 
Event or Problem Description
It was reported that the attachment cutter head cannot be inserted before operation.It was reported there was no patient involvement.Additional information was received stating that detached bearings were found during evaluation.
 
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Brand Name
LEGEND STRAIGHT ATTACHMENT
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
+1(763)526-5677
MDR Report Key50927857
Report Number1625507-2026-08267
Device Sequence Number10722223
Product Code HBB
UDI-Device Identifier00763000084837
UDI-Public(01)00763000084837(11)180920
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K020069
Number of Events Summarized1
Summary Report (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) 09/29/2026
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 NumberAS10S
Device Catalogue NumberAS10S
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer09/28/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/28/2026
Initial Report FDA Received Date09/29/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/20/2018
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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