FDA Adverse Event Malfunction Summary report: N

NAUTILUS REAMER/DRILL GLOVE PROTECTOR

MDR report key: 21021296 · Received December 26, 2024

Report

Report Number
1220246-2024-09063
Event Type
Malfunction
Date Received
December 26, 2024
Date of Event
November 21, 2024
Report Date
July 21, 2025
Manufacturer
ARTHREX, INC.
Product Code
LXH
UDI-DI
00888867192638
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, 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. BASED ON THE INFORMATION PROVIDED WHICH MAY INCLUDE THE DEVICE (IF AVAILABLE AND RETURNED), PICTURES, VIDEOS, EVENT DESCRIPTION, AND ANY ADDITIONAL INFORMATION FROM THE FIELD, ARTHREX WAS ABLE TO CONCLUDE A MOST LIKELY CAUSE. THE MOST LIKELY CAUSE FOR THE REPORTED FAILURE CAN BE ATTRIBUTED TO USER ERROR.

Description of Event or Problem · 0

ON (B)(6) 2024 , A SALES REPRESENTATIVE REPORTED VIA (B)(4) THAT AN AR-9510-01 ARTHREX UNIVERS REVERS¿ VERSION ROD AND AN AR-9216-4 GLENOID REAMER/DRILL GLOVE PROTECTOR BROKE DURING USE. THE CASE WAS COMPLETED SUCCESSFULLY. NO PIECES BROKE OFF INSIDE THE PATIENT. THIS WAS DISCOVERED DURING A REVERSE TOTAL SHOULDER ARTHROPLASTY PROCEDURE ON (B)(6) 2024 , WITH NO REPORTED PATIENT HARM. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2494522 NAUTILUS REAMER/DRILL GLOVE PROTECTOR MANUAL INSTR, GENERAL SURGICAL LXH ARTHREX, INC. NAUTILUS REAMER/DRILL GLOVE PROTECTOR UNK 00888867192638

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown