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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH DRILL BIT Ø2 W/MARKING L110/85 2FLUTE F/; BIT, SURGICAL

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SYNTHES GMBH DRILL BIT Ø2 W/MARKING L110/85 2FLUTE F/; BIT, SURGICAL Back to Search Results
Catalog Number 310.534
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/23/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that on (b)(6) 2024 during the surgical procedure the bits were broken, the procedure was finished without any complications.No other information was provided.This report is for one drill bit ø2 w/marking l110/85 2flute f/.This is report 2 of 2 for (b)(4).
 
Additional 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, h4, h6: 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.
 
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Brand Name
DRILL BIT Ø2 W/MARKING L110/85 2FLUTE F/
Common Device Name
BIT, SURGICAL
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 Key18888440
Report Number8030965-2024-03554
Device Sequence Number7550992
Product Code GFG
UDI-Device Identifier07611819158962
UDI-Public(01)07611819158962
Combination Product (Y/N)N
Initial Reporter CountryCO
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 03/12/2024
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 Number310.534
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/23/2024
Initial Report FDA Received Date03/12/2024
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Unknown
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
DRILL BIT Ø2 W/MARKING L110/85 2FLUTE F/
Patient SexFemale
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