FDA Adverse Event Malfunction Summary report: N

MIDAS REX LEGEND

MDR report key: 21385988 · Received February 14, 2025

Report

Report Number
1625507-2025-00293
Event Type
Malfunction
Date Received
February 14, 2025
Date of Event
March 13, 2023
Report Date
February 14, 2025
Manufacturer
MDT POWERED SURGICAL SOLUTIONS
Product Code
HBB
PMA / PMN Number
K020069
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H3: PRODUCT ANALYSIS: EVALUATION COULD NOT BE PERFORMED BECAUSE OUTPUT SUBASSEMBLY, INTERNAL PARTS AND SUN GEAR CORRODED. THIS REGULATORY REPORT IS BEING SUBMITTED DUE TO A RETROSPECTIVE REVIEW THROUGH CAPA 624392. 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.

Description of Event or Problem · 0

REPAIR REQUEST INITIATED FOR DEVICE WITH THE REPORT OF OVERHEATING. IT WAS REPORTED THAT THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1150835 MIDAS REX LEGEND MOTOR, DRILL, PNEUMATIC HBB MDT POWERED SURGICAL SOLUTIONS AD03

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown