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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY SPINE INC SYMPHONY OCT SYSTEM MULTIPOINT DRILL GUIDE; GUIDE, SURGICAL, INSTRUMENT

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DEPUY SPINE INC SYMPHONY OCT SYSTEM MULTIPOINT DRILL GUIDE; GUIDE, SURGICAL, INSTRUMENT Back to Search Results
Catalog Number 202044101
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/20/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product complaint(b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803 (and/or part 4, as applicable).This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by depuy synthes, or its employees that the report constitutes an admission that the product, depuy synthes, 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 report, a follow-up report will be filed as appropriate.
 
Event or Problem Description
It was reported that this was a posterior cervical discectomy and fusion for opll.During surgery, it was confirmed that the rod that removed the shaft at the end of the nut driver was bent.The surgeon also felt resistance when inserting the trocar, which led him to believe that the tip of the multi point drill guide may have been crushed.The surgery was completed successfully without any surgical delay.No further information is available.
 
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: h3, h4, h6 the product was returned to j&j medtech orthopaedics for evaluation.Visual analysis of the returned sample revealed that the multi point drill guide was heavily deformed at the distal tip.The observed condition of the device was consistent with a random component failure that may have been caused by exposure to unintended forces.Properly handling and attention to the approved use of the device diminishes the risk of failure.A dimensional inspection was unable to be performed due to the post-manufacturing damage.A functional test was not performed since it was not applicable to the complaint condition.The overall complaint was confirmed as the observed condition of the multi point drill guide would have contributed to the complained device issue.Based on the investigation findings, it has been determined that no corrective and/or preventative action is proposed.There is no indication that a design or manufacturing issue has caused the reported complaint condition.As part of j&j medtech orthopaedics quality process, all devices are manufactured, inspected, and released to approved specifications.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.Device history review a review of the receiving inspection (ri) for multi point drill guide was conducted identifying that the lot number was pr145453 released in two batch.Batch 01: lot qty of 200 units were released on 04 feb 2021 with no discrepancies.Batch 02: lot qty of 30 units were released on 03 nov 2020 with no discrepancies.Supplier;(b)(4).As a result, the ri identified no issues during the manufacturing and release of this device that could have contributed to the problem reported by the customer.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
SYMPHONY OCT SYSTEM MULTIPOINT DRILL GUIDE
Common Device Name
GUIDE, SURGICAL, INSTRUMENT
Manufacturer (Section D)
DEPUY SPINE INC
325 paramount drive
raynham MA 02767
Manufacturer Contact
elba bello
325 paramount drive
raynham, MA 02767
9083863534
MDR Report Key22194837
Report Number1526439-2025-00756
Device Sequence Number9310984
Product Code FZX
UDI-Device Identifier10705034532684
UDI-Public(01)10705034532684(10)PR145453
Combination Product (Y/N)N
Initial Reporter CountryJA
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 Number202044101
Device Lot NumberPR145453
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/11/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 05/19/2025
Supplement Date Received by Manufacturer06/25/2025
Initial Report FDA Received Date06/12/2025
Supplement Report FDA Received Date06/26/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/03/2020
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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