MAUDE Adverse Event Report: WRIGHTS LANE SYNTHES USA PRODUCTS LLC 2.4/3.0MM CRUCIFORM SCRWDRVR BLADE WITH HEX COUPLING; SCREWDRIVERS

Model Number	313.939
Medical Device Problem Code	Break (1069)
Health Effect - Clinical Code	No Consequences Or Impact To Patient (2199)
Date of Event	06/22/2020
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Complainant part is not expected to be returned for manufacturer review/investigation.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.
Event or Problem Description
Device report from synthes reports an event in canada as follows: it was reported that on (b)(6) 2020 during a sternal closure case, the cruciform screwdriver blade tip broke on one blade during use and the second blade was bent.There was no patient consequence.Fragments were generated and easily removed.There was no surgical delay.The procedure was successfully completed.Concomitant device reported: unknown screw (part# unknown, lot# unknown, quantity# unknown).This complaint involves 2 devices.This report is for 1 2.4/3.0mm cruciform scrwdrvr blade with hex coupling.This is report 1 of 1 for (b)(4).

• Brand Name: 2.4/3.0MM CRUCIFORM SCRWDRVR BLADE WITH HEX COUPLING
• Common Device Name: SCREWDRIVERS
• Manufacturer (Section D): WRIGHTS LANE SYNTHES USA PRODUCTS LLC; 1302 wrights lane east; west chester PA 19380
• MDR Report Key: 10241862
• Report Number: 2939274-2020-03149
• Device Sequence Number: 2432575
• Product Code: HXX
• UDI-Device Identifier: 10887587037127
• UDI-Public: (01)10887587037127
• Combination Product (Y/N): N
• Initial Reporter Country: CA
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: company representative,foreig
• Initial Reporter Occupation: Physician
• Type of Report: Initial
• Report Date (Section B): 06/23/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Operator of Device: Health Professional
• Device Model Number: 313.939
• Device Catalogue Number: 313.939
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 06/23/2020
• Initial Report FDA Received Date: 07/07/2020
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1