MAUDE Adverse Event Report: WALDEMAR LINK GMBH & CO. KG LCU - HIP SYSTEM; UNIVERSAL HANDLE, WITH QUICK COUPLING, STAINLESS STEEL, STRAIGHT

Model Number	130-394/01
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	02/10/2025
Type of Reportable Event	Malfunction
Event or Problem Description
The universal handle broke during surgery.[customer].
Additional Manufacturer Narrative
The review of the device history record showed no deviations.The product complies with the specifications valid at the time of manufacture.This is the final supplemental report, the complaint is closed.
Event or Problem Description
The unviversal handle broke during surgery.[customer].

• Brand Name: LCU - HIP SYSTEM
• Common Device Name: UNIVERSAL HANDLE, WITH QUICK COUPLING, STAINLESS STEEL, STRAIGHT
• Manufacturer (Section D): WALDEMAR LINK GMBH & CO. KG; barkhausenweg 10; hamburg, 22339 ,; GM 22339,
• Manufacturer Contact: andreas brandt ; barkhausenweg 10; hamburg, 22339 ; GM 22339
• MDR Report Key: 21537231
• Report Number: 3004371426-2025-00010
• Device Sequence Number: 7000212
• Product Code: LXH
• UDI-Device Identifier: 04026575215539
• UDI-Public: 04026575215539
• Combination Product (Y/N): N
• Initial Reporter Country: RO
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Foreign,Health Professional
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 02/13/2025

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
• Device Model Number: 130-394/01
• Device Catalogue Number: 130-394/01
• Device Lot Number: C332137
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 03/03/2025
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 02/13/2025
• Supplement Date Received by Manufacturer: 02/13/2025
• Initial Report FDA Received Date: 03/06/2025
• Supplement Report FDA Received Date: 08/27/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 02/08/2024
• 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: Reuse
• Patient Sequence Number: 1
• Patient Sex: Unknown