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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH MATRIXRIB DRILL BIT Ø2.2 W/STOP L135/12; BIT, DRILL

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SYNTHES GMBH MATRIXRIB DRILL BIT Ø2.2 W/STOP L135/12; BIT, DRILL Back to Search Results
Catalog Number 03.501.042
Medical Device Problem Code Material Integrity Problem (2978)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/19/2025
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.H11 additional manufacturer narrative: e1 initial reporter address line 1: (b)(6).H3, h6: part: 03.501.042.Synthes lot: u404998.Supplier lot: u404998.Release to warehouse date: 10 may 2022.Supplier: (b)(4).No ncrs were generated during production.Review of the device history record(s) showed that there were no issues during the manufacture of this product, and any sub-components, which would contribute to this complaint condition.The product was not returned to medtech orthopaedics, however photos were provided for review.The photo investigation revealed that '03.501.042, matrixrib drill bit ø2.2 w/stop l135/12¿ had broken tip.The observed condition of the device was consistent with a random component failure that may have been caused by exposure to unintended forces.Since the device was not returned, a dimensional inspection cannot be performed.The overall complaint was confirmed as the observed condition of the matrixrib drill bit ø2.2 w/stop l135/12 would contribute to the complained device issue.Based on the investigation findings, potential cause can be attributed to component failure 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 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.
 
Event or Problem Description
It was reported that the self-fastening long screwdriver part has the tip very worn and does not have good grip of the screws.There was no discomfort of the specialist, the surgery ended successfully.
 
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Brand Name
MATRIXRIB DRILL BIT Ø2.2 W/STOP L135/12
Common Device Name
BIT, DRILL
Manufacturer (Section D)
SYNTHES GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
Manufacturer (Section G)
MONUMENT
1101 synthes avenue
monument CO 80132
Manufacturer Contact
elba bello
1302 wright lane east
west chester, PA 19380
9083863534
MDR Report Key22676179
Report Number8030965-2025-07860
Device Sequence Number9447740
Product Code HTW
UDI-Device Identifier07611819348844
UDI-Public(01)07611819348844(10)U404998
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,Distributor
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
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 Number03.501.042
Device Lot NumberU404998
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 07/17/2025
Initial Report FDA Received Date07/31/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/10/2022
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 SexFemale
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