FDA Adverse Event Malfunction Summary report: N

BIO-COMP, SWIVELOCK C, FT, 4.75X19.1MM

MDR report key: 23135200 · Received September 24, 2025

Report

Report Number
1220246-2025-04113
Event Type
Malfunction
Date Received
September 24, 2025
Date of Event
September 4, 2025
Report Date
October 24, 2025
Manufacturer
ARTHREX, INC.
Product Code
MAI
PMA / PMN Number
K101823
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
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. COMPLAINT ALLEGATION IS NOT CONFIRMED BY THE ATTACHED PICTURE, WHICH SHOWS THE ANCHOR, THE EYELET, AND THE SUTURES DID NOT HAVE ANY VISUAL ISSUES. 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. PER PICTURES EVALUATION NO PROBLEM WAS FOUND WITH THE IMPLANTS.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A SURGERY THE ANCHOR BROKE DURING INSERTION. PER COMPLAINT REPORTER THERE WAS NO HARM FOR PATIENT, OPERATOR OR THIRD PARTY. NO FURTHER INFORMATION RECEIVED. UPDATE AVOE 12-SEP-2025 THE DEVICE WON`T BE RETURNED AS IT REMAINED INSIDE THE PATIENT. UPDATE AVOE 13-SEP-2025 IT WAS CONFIRMED THAT THE FAILURE OCCURRED DURING A ROTATOR CUFF REPAIR SURGERY. PER COMPLAINT REPORTER THERE WAS NO HARM FOR PATIENT, OPERATOR OR THIRD PARTY. THE SURGERY WAS FINISHED SUCCESSFULLY WITH A DIFFERENT DEVICE. IT WAS NOT NECESSARY TO SWITCH THE SURGICAL TECHNIQUE OR DO A SECOND SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2430617 BIO-COMP, SWIVELOCK C, FT, 4.75X19.1MM BIO SOFT TISSUE FIXATN FASTNR MAI ARTHREX, INC. BIO-COMP, SWIVELOCK C, FT, 4.75X19.1MM 15403351

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown