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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH 4.3MM PERCUTANEOUS DRILL BIT QC/300MM/CALIBRATED; BIT, DRILL

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SYNTHES GMBH 4.3MM PERCUTANEOUS DRILL BIT QC/300MM/CALIBRATED; BIT, DRILL Back to Search Results
Catalog Number 324.213
Medical Device Problem Codes Break (1069); Entrapment of Device (1212)
Health Effect - Clinical Code Foreign Body In Patient (2687)
Date of Event 11/08/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product complaint # (b)(4).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.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
It was reported that during the use of the 4.3 bit, it was broken inside the bone.No further details were provided.
 
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.H11 additional narrative: added: b5, h6 (health effect - impact code) h3, h6: product was not returned.Based on the information available, it has been determined that no corrective and 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 history review (dhr): a manufacturing record evaluation was performed for the finished device product code: 342.213 lot number: 4506p64 it was electronically reviewed and no nonconformances/manufacturing irregularities were identified during the manufacturing process.The product was released on: 20 feb 2023.Manufacturing site: jabil bettlach.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
Additional information was received and states that; a.Was there a surgical delay in relation to the reported event? - yes b.Was the surgery completed successfully? - yes c.Were fragments generated? if so, were they easily removed without additional intervention? - yes, it was not possible to remove the drill bit.D.Could you provide us with the patient's condition? - implanted drill bit part.E.Were there any allegations against cortscr ø4.5 self-tapping l60 sst (214.860) - no.
 
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Brand Name
4.3MM PERCUTANEOUS DRILL BIT QC/300MM/CALIBRATED
Common Device Name
BIT, DRILL
Manufacturer (Section D)
SYNTHES GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
Manufacturer (Section G)
WERK BETTLACH (CH)
muracherstrasse 3
bettlach 2544
SZ   2544
Manufacturer Contact
kate karberg
1302 wright lane east
west chester, PA 19380
3035526892
MDR Report Key20707982
Report Number8030965-2024-14045
Device Sequence Number15498877
Product Code HTW
UDI-Device Identifier07611819915350
UDI-Public(01)07611819915350(10)4506P64
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,Followup
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 Number324.213
Device Lot Number4506P64
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 11/08/2024
Supplement Date Received by Manufacturer12/05/2024
Initial Report FDA Received Date11/18/2024
Supplement Report FDA Received Date12/10/2024
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/17/2023
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 Number1
Patient SexUnknown
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