MAUDE Adverse Event Report: SYNTHES GMBH DRILLSL 5/2.9 F/03.122.053; GUIDE, SURGICAL, INSTRUMENT

Catalog Number 03.122.054

Device Problems Device-Device Incompatibility (2919); Material Twisted/Bent (2981)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Type  malfunction  

Event Description

Device report from synthes reports an event in (b)(6)as follows: it was reported that on an unknown date, during inspection, the instruments were difficult to disassemble from one another once they were assembled.There was no patient involvement.No further information provided.This report is for one (1) drillsl 5/2.9 f/03.122.053.This is report 5 of 12 for (b)(4).

Manufacturer Narrative

Additional narrative: device is not distributed in the united states, but is similar to device marketed in the usa.Initial reporter is synthes sales representative.Without a lot number the device history records review could not be completed.Product was not returned.Based on the information available, it has been determined that no corrective and/or preventative action is proposed.This complaint will be accounted for and monitored via post market surveillance activities.If additional information is made available, the investigation will be updated as applicable.Device was used for treatment, not diagnosis.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.

• Brand Name: DRILLSL 5/2.9 F/03.122.053
• Type of Device: GUIDE, SURGICAL, INSTRUMENT
• Manufacturer (Section D): SYNTHES GMBH; eimattstrasse 3; oberdorf 4436 ; SZ 4436
• Manufacturer (Section G): WERK HÄGENDORF (CH); im bifang 6; haegendorf 4614 ; SZ 4614
• Manufacturer Contact: kara ditty-bovard ; 1302 wrights lane east; west chester, PA 19380 ; 6103142063
• MDR Report Key: 13634234
• MDR Text Key: 293346516
• Report Number: 8030965-2022-01203
• Device Sequence Number: 1
• Product Code: FZX
• UDI-Device Identifier: 07611819394490
• UDI-Public: (01)07611819394490
• Combination Product (y/n): N
• Reporter Country Code: UK
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Foreign,Company Representative
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 03/01/2022
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: 03.122.054
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Date Manufacturer Received: 02/01/2022
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Unknown
• Patient Sequence Number: 1
• Treatment: CENT-SLEEVE F/K-WIRE Ø1.6 F/03.122.054.; DRILLSL 5/2.9 F/03.122.053.; OUTERSLEEVE 6/5 F/PHILOS AIM-DEVICE.