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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH HANDLE WITH HEX COUPLING; BIT, DRILL

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SYNTHES GMBH HANDLE WITH HEX COUPLING; BIT, DRILL Back to Search Results
Catalog Number 03.130.005
Device Problem Device-Device Incompatibility (2919)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 12/07/2023
Event Type  malfunction  
Manufacturer Narrative
Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.If the information is unknown, not available or does not apply, the section/field of the form is left blank.H10 additional narrative: e1: initial reporter is j&j company representative h3, h6: the investigation could not be completed; no conclusion could be drawn, as no product was received.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.
 
Event Description
It was reported that on (b)(6) 2023, during postoperative inspection of the set, it was noted that the t6 screwdriver shaft was stuck in the screwdriver handle.The device has been through sterile processing, but it cannot be completely sterilized per hospital standards because the screwdriver shaft is stuck in the handle.The latch mechanism on the screwdriver handle is stuck and is not allowing the screwdriver shaft to disconnect with the handle.No patient involvement.This report is for handle with hex coupling for (b)(4).
 
Manufacturer Narrative
Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.H3, h4, h6 investigation summary the device associated with this report was returned to depuy synthes for evaluation.Visual analysis of the returned sample revealed that there was no damage or defects with the handle with hex coupling.The allegation cannot be confirmed.A dimensional inspection was performed for the handle with hex coupling and met specifications.A functional test was performed with the mating devices and assemble and disassemble with no problem.The overall complaint was unconfirmed as the observed condition of the handle with hex coupling would not contribute to the complained device issue.Based on the investigation findings, 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.Drawing/specifications reviewed? reviewed dimensional inspection: n/a.Device history part: 03.130.005 , lot: 9534953, manufacturing site: werk hagendorf , supplier: na, release to warehouse date: 17 sep 2015, expiration date: na.A manufacturing record evaluation was performed for the finished article lot and no non-conformances were identified.
 
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Brand Name
HANDLE WITH HEX COUPLING
Type of Device
BIT, DRILL
Manufacturer (Section D)
SYNTHES GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
Manufacturer (Section G)
WERK HAGENDORF
im bifang 6
hagendorf CO 4614
SZ   4614
Manufacturer Contact
kate karberg
1302 wright lane east
west chester, PA 19380
3035526892
MDR Report Key18419134
MDR Text Key331676982
Report Number8030965-2023-16349
Device Sequence Number1
Product Code HTW
UDI-Device Identifier10886982075185
UDI-Public(01)10886982075185
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/29/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number03.130.005
Device Lot Number9534953
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Date Manufacturer Received01/29/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured09/17/2015
Is the Device Single Use? No
Type of Device Usage Unknown
Patient Sequence Number1
Treatment
SD SCRWDRVR SHFT/T6 50/SELF-RETAIN/HXC
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