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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY SPINE INC EXPEDIUM SPINE SYSTEM QUICK CONNECT SI POLY DRIVER; SCREWDRIVER

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DEPUY SPINE INC EXPEDIUM SPINE SYSTEM QUICK CONNECT SI POLY DRIVER; SCREWDRIVER Back to Search Results
Catalog Number 279712400
Medical Device Problem Code Material Twisted/Bent (2981)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/22/2025
Type of Reportable Event Malfunction
Event or Problem Description
The surgeon was performing a t10 to pelvis surgery on a patient with very hard bone.During the process, the expedium probe and four polyaxial screwdrivers got stripped at the distal end tip.No consequences were experienced from a patient's perspective and there were no delays as spares were readily available.The procedure was completed successfully.
 
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.
 
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, h6: the product was not returned to medtech orthopaedics; however photos were provided for review.The photo investigation revealed that 279712400, xpdm quick-con si poly scwdrvr had stripped/worn/twisted/cross threaded.The device exhibits damage consistent with repeated use.The lifecycle requirements of the device are event related and depend on the use and inspection of the device in clinical practice.As the device can be damaged on the first or 100th use, the device must be properly inspected prior to each surgical use.Refer to the device/country specific ifu for information related to end of life, reprocessing instructions, and inspection procedures.Since the device was not returned, a dimensional inspection cannot be performed.The overall complaint was confirmed as the observed condition of the xpdm quick-con si poly scwdrvr would contribute to the complained device issue.Based on the investigation findings, the xpdm quick-con si poly scwdrvr has stripped/worn/twisted/cross threaded because of end of life and 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 complaint condition.As part of medtech orthopedics 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 xpdm quick-con si poly scwdrvr was conducted identifying that the lot number was mi148385 released in one batch.Batch 01: lot qty of (b)(4) units were released on 06 feb 2024 with no discrepancies.Supplier: micropulse incorporated.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
EXPEDIUM SPINE SYSTEM QUICK CONNECT SI POLY DRIVER
Common Device Name
SCREWDRIVER
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 Key22459919
Report Number1526439-2025-00874
Device Sequence Number18280476
Product Code HXX
UDI-Device Identifier10705034198897
UDI-Public(01)10705034198897(10)MI148385
Combination Product (Y/N)N
Initial Reporter CountryCA
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 Number279712400
Device Lot NumberMI148385
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 06/22/2025
Supplement Date Received by Manufacturer07/18/2025
Initial Report FDA Received Date07/09/2025
Supplement Report FDA Received Date07/21/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/07/2024
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 Unknown
Patient Sequence Number1
Patient SexUnknown
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