MAUDE Adverse Event Report: DEPUY MITEK LLC US GRYPHON 2.4MM DRILL BIT; BIT, DRILL

Catalog Number	211036
Medical Device Problem Code	Break (1069)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	07/05/2024
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported, by the sales rep in (b)(6) on 7/5/2024.That during, a joint lip arthroplasty for left shoulder performed.Drilling was performed to create a bone hole for inserting the third implant into near the anterior superior edge of the glenoid.The gryphon 2.4mm drill bit was broken at the border between the stopper and the shaft on the drill side.At the surgeon¿s discretion, the broken shaft side was installed to the power tool and the surgeon drilled through the guide.Then, the implant was deployed.The surgeon confirmed, that it was fixed without problems and suturing was performed.There was no surgical delay.The surgeon was aware, that the cause was clearly a misdirection of drilling by the assistant surgeon.There were no adverse patient consequences reported.No additional information was provided.
Additional Manufacturer Narrative
This report is being submitted in pursuant to the provisions of 21 cfr, part 803.This report may be based on information, which has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by depuy mitek or its employees that the report constitutes an admission that the device, depuy mitek, or its employees caused or contributed to the potential event described in this report.If information is obtained, that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.The complaint device is not being returned, it was retained by the customer.Therefore, unavailable for a physical evaluation.Since, the complaint device was not returned.We cannot determine, a root cause for the reported failure.If additional information or the device is received in the future, we will reopen the complaint.And perform the investigation as appropriate.Given that, no lot number was provided.A manufacturing record evaluation (mre) review cannot be performed.If the lot number becomes available, the mre review will be performed.At this point in time, no corrective action is required.And no further action is warranted.However, depuy synthes mitek will continue to track any related complaints within this device family.As a means of monitoring the extent with, which this complaint is observed in the field.Udi: (b)(4).

• Brand Name: GRYPHON 2.4MM DRILL BIT
• Common Device Name: BIT, DRILL
• Manufacturer (Section D): DEPUY MITEK LLC US; 325 paramount drive; raynham MA 02767
• Manufacturer (Section G): DEPUY MITEK LLC US; 325 paramount drive; raynham MA 02767
• Manufacturer Contact: kate karberg ; 325 paramount drive; raynham, MA 02767 ; 3035526892
• MDR Report Key: 19742620
• Report Number: 1221934-2024-02461
• Device Sequence Number: 19758217
• Product Code: HTW
• UDI-Device Identifier: 10886705001484
• UDI-Public: 10886705001484
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Foreign,Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 07/15/2024

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 Number: 211036
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 07/05/2024
• Initial Report FDA Received Date: 07/15/2024
• Was Device Evaluated by Manufacturer? (Y/N): No
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Unknown
• Patient Sequence Number: 1
• Patient Sex: Unknown