FDA Adverse Event Injury Summary report: N

UNK

MDR report key: 23156258 · Received September 26, 2025

Report

Report Number
1220246-2025-04171
Event Type
Injury
Date Received
September 26, 2025
Date of Event
August 15, 2025
Report Date
November 12, 2025
Manufacturer
ARTHREX, INC.
Product Code
MDM
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SW
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 ¿ INCLUDING THE RETURNED DEVICE (IF AVAILABLE), PHOTOGRAPHS, VIDEOS, EVENT DESCRIPTION, AND ANY ADDITIONAL FIELD INPUT ¿ ARTHREX HAS DETERMINED THE MOST LIKELY CAUSE OF THE REPORTED EVENT. THE MOST LIKELY CAUSE IS A PATIENT-SPECIFIC EVENT, CONSISTENT WITH DFU GUIDANCE, WHICH STATES THAT ALLERGIC RESPONSES TO IMPLANT MATERIALS MAY OCCUR IN RARE CASES.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A REVISION SURGERY OF A SHOULDER PROSTHESIS, IT WAS NOT POSSIBLE TO USE THE AR-9401-17 IN THE NOTCHES AS USUAL. INSTEAD, THE IMPLANT HAD TO BE BROKEN UP AND THE EXTRACTION INSTRUMENT BROKE. IN ADDITION, AR-9545-T15-02 WAS WORN OUT ON ARRIVAL. THE DEVICE COULD BE USED DURING SURGERY BUT SHOULD NOT BE USED AGAIN. THE SURGERY WAS FINISHED SUCCESSFULLY WITH THE SAME DEVICES. IT WAS NOT NECESSARY TO SWITCH THE SURGICAL TECHNIQUE OR DO A SECOND SURGERY. UPDATE CMACKENBACH 12-SEP-25 MORE INFORMATION WAS PROVIDED THAT THE REVISION SURGERY WAS ACTUALLY THE REVISION OF AN UNKNOWN ARTHREX IMPLANT DUE TO AN INFECTION. THIS LINE IS ADDED FOR THE UNKNOWN IMPLANT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
303227 UNK MANUAL INSTR, GENERAL SURGICAL MDM ARTHREX, INC. UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other