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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH DRILL BIT Ø1.1 W/STOP L44.5/6; DRILL, BONE, POWERED

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SYNTHES GMBH DRILL BIT Ø1.1 W/STOP L44.5/6; DRILL, BONE, POWERED Back to Search Results
Catalog Number 03.503.286
Device Problem Failure to Cut (2587)
Patient Problem Insufficient Information (4580)
Event Date 02/12/2024
Event Type  malfunction  
Event Description
Device report from colombia reports an event as follows: it was reported that on (b)(6) 2024, the drill bits were found to be dull and would not cut.It was necessary to exert more pressure for it to enter the bone.There was no reported adverse patient impact.No further information is available.This report is for a drill bit ø1.1 w/stop l44.5/6.This is report 2 of 2 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.If the information is unknown, not available or does not apply, the section/field of the form is left blank.D9: complainant part is not expected to be returned for manufacturer review/investigation.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.
 
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.H6: device history record (dhr) review conducted: part # 03.503.286, synthes lot # u406180, supplier lot # u406180, release to warehouse date: 11 aug 2022, supplier : (b)(4).No ncrs were generated during production.Review of the device history record(s) showed that there were no issues during the manufacture of this product, and any sub-components, which would contribute to this complaint condition.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.
 
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Brand Name
DRILL BIT Ø1.1 W/STOP L44.5/6
Type of Device
DRILL, BONE, POWERED
Manufacturer (Section D)
SYNTHES GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
Manufacturer (Section G)
MONUMENT
1101 synthes avenue
monument CO 80132
Manufacturer Contact
kate karberg
1302 wright lane east
west chester, PA 19380
3035526892
MDR Report Key18778197
MDR Text Key336433292
Report Number8030965-2024-02889
Device Sequence Number1
Product Code DZI
Combination Product (y/n)N
Reporter Country CodeCO
PMA/PMN Number
K043310
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/26/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number03.503.286
Device Lot NumberU406180
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received03/04/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured08/11/2022
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
Treatment
DRILL BIT Ø1.1 W/STOP L44.5/6
Patient Age76 YR
Patient SexMale
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