FDA Adverse Event Malfunction Summary report: N

HEALIX ADVANCE ORTHOCORD

MDR report key: 24831326 · Received April 9, 2026

Report

Report Number
1221934-2026-01465
Event Type
Malfunction
Date Received
April 9, 2026
Date of Event
March 31, 2026
Manufacturer
DEPUY MITEK LLC US
Product Code
MAI
UDI-DI
10886705021321
PMA / PMN Number
K120078
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUBMITTED PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH HAS NOT BEEN INVESTIGATED OR VERIFIED PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY DEPUY SYNTHES, OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE PRODUCT, DEPUY SYNTHES, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE. H11 ADDITIONAL NARRATIVE: AS OF THIS DATE, THE DEVICE HAS NOT BEEN RETURNED FOR EVALUATION; THEREFORE, THE REPORTED CONDITION CANNOT BE CONFIRMED AND/OR DUPLICATED, AND NO CONCLUSION CAN BE DRAWN AT THIS TIME. ACCORDING TO THE INFORMATION RECEIVED: ¿ANCHOR BREAKAGE. IT WAS REPORTED THAT DURING THE SURGERY, THE ANCHOR WAS BROKEN OFF, REMOVED ALL THE BROKEN PARTS (AS THE ATTACHED PHOTO SHOWS). ANOTHER DEVICE WAS USED TO COMPLETE THE SURGERY. THERE WERE NO ADVERSE CONSEQUENCES TO THE PATIENT. NO ADDITIONAL INFORMATION COULD BE PROVIDED.¿ THE PRODUCT WAS NOT RETURNED TO DEPUY SYNTHES, HOWEVER A PHOTO WAS PROVIDED FOR EVALUATION. VISUAL INSPECTION OF THE RETURNED PHOTO FOUND THE ANCHOR DETACHED FROM THE INSERTER AND BROKEN AT DISTAL END. THE DEVICE HAD FOREIGN MATTER, PRESUMABLY BIOLOGICAL MATTER. NO OTHER ANOMALIES WERE NOTED. THE OVERALL COMPLAINT WAS CONFIRMED AS THE OBSERVED CONDITION OF THE 4.5 HEALIX ADVANCE BR3SUT W/OC WOULD HAVE CONTRIBUTED TO THE COMPLAINED DEVICE ISSUE. BASED ON THE INVESTIGATION FINDINGS, THE POTENTIAL CAUSE IS TRACED TO OFF-AXIS INSERTION AND LEVERING DURING INSERTION. AS PER IFU-100191, 1) INSERTING THE AWL OR DRILL TO LESS THAN THE SPECIFIED DEPTH, AXIAL MISALIGNMENT OR LEVERING WITH THE ANCHOR UPON INSERTION MAY RESULT IN ANCHOR FRACTURE. 2) DO NOT APPLY A BENDING FORCE TO THE INSERTER. THIS CAN DAMAGE THE ANCHOR OR INSERTER TIP. 3) APPLY TENSION (NORMAL FORCE) ON SUTURE LENGTHS. EXCESSIVE FORCE MAY OVERLOAD THE ANCHOR OR SUTURE. PROPERLY HANDLING AND ATTENTION TO THE APPROVED USE OF THE DEVICE DIMINISHES THE RISK OF FAILURE. IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND/OR PREVENTATIVE ACTION IS PROPOSED. THERE IS NO INDICATION THAT A DESIGN OR MANUFACTURING ISSUE HAS CAUSED THE REPORTED COMPLAINT CONDITION. AS PART OF DEPUY SYNTHES QUALITY PROCESS, ALL DEVICES ARE MANUFACTURED, INSPECTED, AND RELEASED TO APPROVED SPECIFICATIONS. ADDITIONAL MONITORING FOR ANY POTENTIAL SAFETY SIGNALS WILL BE CONDUCTED THROUGH COMPLAINT TRENDING AND OTHER POST-MARKET SAFETY SURVEILLANCE ACTIVITIES. DOCUMENT SPECIFICATION REVIEW: IFU-100191. DEVICE HISTORY LOT: PRODUCT CODE: 222296. LOT NO: 252L737. THERE WAS A NON-CONFORMANCE NR-0215765 NOT RELATED. MANUFACTURING DATE: 24-NOV-2023. EXPIRATION DATE: 31-OCT-2026. DEVICE HISTORY BATCH: NULL. E1: THE REPORTER¿S COMPLETE FACILITY ADDRESS WAS NOT PROVIDED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AN ARTHROSCOPIC ROTATOR CUFF REPAIR PROCEDURE THAT THE 4.5 HEALIX ADVANCE BR3SUT W/OC ANCHOR DEVICE BROKE OFF. ALL BROKEN PARTS WERE REMOVED. ANOTHER DEVICE WAS USED TO COMPLETE THE PROCEDURE. THERE WAS NO DELAY IN THE PROCEDURE REPORTED. THERE WERE NO ADVERSE PATIENT CONSEQUENCES REPORTED. ALL AVAILABLE INFORMATION HAS BEEN DISCLOSED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
483273 HEALIX ADVANCE ORTHOCORD FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE MAI DEPUY MITEK LLC US 252L737 10886705021321

Patients

Seq Age Sex Outcome Treatment
1