MAUDE Adverse Event Report: SYNTHES GMBH LID FOR BATTERY HANDPIECE MODULAR, TRS; MOTOR, SURGICAL INSTRUMENT, AC-POWERED

Catalog Number	05.001.227
Medical Device Problem Codes	Device-Device Incompatibility (2919); Fail-Safe Did Not Operate (4046)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	07/15/2021
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Device was used for treatment, not diagnosis.If information is obtained that was not available for this medwatch, a supplemental medwatch report will be filed as appropriate.The actual device was returned for evaluation.During repair, an evaluation was performed and it was determined that the reported condition was confirmed.The assignable root cause of this condition was determined to be traced to component failure due to wear.(b)(4).
Event or Problem Description
It was reported from the (b)(6) that during service and evaluation, it was determined that the lid of the handpiece device had component damage, the device would run in the locked position, the device failed leak tightness test, the locking mechanism was stiff/stuck, and the locking mechanism did not function.It was further determined that the device failed pretest for check in ¿lock¿ mode, check function of the mode switch knob, leakage test, and check the locking function with the handpiece.It was noted in the service order that the reverse does not work, and the lid cannot be put on place properly.This event did not occur during surgery.There was no patient involvement.There were no reports of injuries, medical intervention, or prolonged hospitalization.All available information has been disclosed.If additional information should become available, a supplemental medwatch will be submitted accordingly.

• Brand Name: LID FOR BATTERY HANDPIECE MODULAR, TRS
• Common Device Name: MOTOR, SURGICAL INSTRUMENT, AC-POWERED
• Manufacturer (Section D): SYNTHES GMBH; eimattstrasse 3; oberdorf 4436 ; SZ 4436
• MDR Report Key: 12554375
• Report Number: 8030965-2021-08155
• Device Sequence Number: 19704885
• Product Code: GEY
• UDI-Device Identifier: 07611819978041
• UDI-Public: 07611819978041
• Combination Product (Y/N): N
• Initial Reporter Country: NL
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: company representative,foreig
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 07/15/2021

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 Catalogue Number: 05.001.227
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 07/30/2021
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 09/27/2021
• Initial Report FDA Received Date: 09/30/2021
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1