FDA Adverse Event Malfunction Summary report: N

45MM PERIPHERAL REAMER

MDR report key: 20653742 · Received November 11, 2024

Report

Report Number
1220246-2024-08506
Event Type
Malfunction
Date Received
November 11, 2024
Date of Event
October 29, 2024
Report Date
August 21, 2025
Manufacturer
ARTHREX, INC.
Product Code
LXH
UDI-DI
00888867308930
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

INVESTIGATION IS IN PROCESS. A FOLLOW-UP REPORT WILL BE PROVIDED UPON AVAILABILITY OF ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: G3, H3, H6. VISUAL EVALUATION OF THE CUSTOMER-PROVIDED PICTURES NOTED AN AR-9619-45 45MM REAMER BROKE. REFER TO ATTACHMENTS. THE COMPLAINT ALLEGATION IS CONFIRMED BASED ON THE CUSTOMER-PROVIDED PICTURES. BASED ON THE INFORMATION PROVIDED, ARTHREX WAS ABLE TO CONCLUDE A MOST LIKELY CAUSE. THE MOST LIKELY CAUSE FOR THE REPORTED FAILURE CAN BE ATTRIBUTED TO USER ERROR DUE TO MISALIGNED INSERTION AND/OR PRYING/LEVERAGING THE DEVICE DURING USE.

Description of Event or Problem · 0

ON (B)(6) 2024, A SALES REPRESENTATIVE REPORTED VIA (B)(4) THAT AN AR-9619-45 45MM REAMER BROKE DURING A CASE. ALL BROKEN PIECES WERE RETRIEVED, AND THE CASE WAS CONTINUED. LATER, DURING THE CASE, THE AR-9530L-03 REVERS TRIAL WAS USED, AND THE REP NOTICED IT HAD A LOT OF WEAR AND TEAR AND WOULD NEED TO BE REPLACED FOR THE NEXT TIME. IT WAS USED A LOT, AND PIECES WERE FALLING OFF. THE REP CONFIRMED NOTHING FELL INTO THE PATIENT TRIAL, AND THE CASE WAS COMPLETED SUCCESSFULLY WITHOUT A SIGNIFICANT DELAY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1047987 45MM PERIPHERAL REAMER ORTHOPEDIC MANUAL SURG INSTR LXH ARTHREX, INC. 45MM PERIPHERAL REAMER 021939 00888867308930

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown