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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY IRELAND - 3015516266 RECLM MONO REAMER EXTENSION; HIP INSTRUMENT - REAMER

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DEPUY IRELAND - 3015516266 RECLM MONO REAMER EXTENSION; HIP INSTRUMENT - REAMER Back to Search Results
Catalog Number 440000032
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/22/2025
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.This report may be based on information that has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by depuy synthes joint reconstruction, or its employees that the report constitutes an admission that the product, depuy synthes joint reconstruction, or its employees caused or contributed to the potential event described in this report.H11 additional narrative: added : d9.If information that was not available for the initial report is obtained, a follow-up report will be filed as appropriate.
 
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 the surgeon used a mallet and broke the reamer guide.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).Investigation summary: it was reported that the surgeon used a mallet and broke the reamer guide.The product was returned to j&j medtech orthopaedics for evaluation.Visual analysis of the returned device found that the reclm mono reamer extension was broken at the distal section, the fragment remained attached to the main device.Additionally, the sample exhibits signs of heavy usage for a long period of time.The observed condition of the device was consistent with a component failure that was caused by exposure to unintended forces like impacting the mating device in a misaligned position, heavy usage or by improper handling or care.Properly handling and attention to the approved use of the device diminishes the risk of failure.A functional test was unable to be performed due to the post-manufacturing damage.A dimensional inspection was unable to be performed due to the post-manufacturing damage.The overall complaint was confirmed as the observed condition of the reclm mono reamer extension would have contributed to the complained 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 lot: the product investigation found no evidence suspecting an error in the manufacturing or material that would be a contributing factor in the reported allegation(s).A manufacturing records evaluation (mre) was not performed.H.11.Additional narrative: corrected: h3.
 
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Brand Name
RECLM MONO REAMER EXTENSION
Common Device Name
HIP INSTRUMENT - REAMER
Manufacturer (Section D)
DEPUY IRELAND - 3015516266
loughbeg ringaskiddy co.
cork
EI 
Manufacturer Contact
elba bello
700 orthopaedic dr.
warsaw, IN 46581
9083863534
MDR Report Key22726925
Report Number1818910-2025-13764
Device Sequence Number20920897
Product Code HTO
UDI-Device Identifier10603295537250
UDI-Public(01)10603295537250(10)SO2064226
Combination Product (Y/N)N
Initial Reporter StateMA
Initial Reporter CountryUS
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 Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup,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 Number440000032
Device Lot NumberSO2064226
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 07/22/2025
Supplement Date Received by Manufacturer08/12/2025
09/19/2025
Initial Report FDA Received Date08/06/2025
Supplement Report FDA Received Date08/13/2025
09/19/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/05/2023
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 SexMale
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