MAUDE Adverse Event Report: SYNTHES GMBH RFNA/ 11MM/ 400MM/ STANDARD BEND/ STER; ROD, FIXATION, INTRAMEDULLARY AND ACCESSORIES

Catalog Number	04.233.140S
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code	Bone Fracture(s) (1870)
Type of Reportable Event	Serious Injury
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.H.11.Additional narrative: h3, h6: product was not returned.Based on the information available, it has been determined that no corrective and preventative action is proposed.This complaint will be accounted for and monitored via post market surveillance activities.If additional information is made available, the investigation will be updated as applicable.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Event or Problem Description
Subject id: (b)(6) study no: (b)(4).Clinical adverse event received for left femoral neck fracture - peri-implant device and procedure(relatedness).Device related: possible, procedure related: not related.Date of event: 05 jun 2025.Date of implant: (b)(6) 2024.Date of revision: no information provided.Device location: left.Treatment/impact: required in-patient hospitalization or prolongation of existing hospitalization, resulted in medical or surgical intervention to prevent life-threatening illness or injury or permanent impairment to a body structure or a body function, surgical intervention not at the fracture site (deep hardware removal and open reduction internal fixation femoral neck fracture: both 4.5 cortical screws were removed.They were obviously bent.Replaced them with 6.5 mm cancellous screws.Guidewires for planned placement of two 6.5 cannulated screws.Checked the guidewires on multiple fluoroscopic views and found to be in good position alignment.We used a drill to drill the lateral cortex.We then advanced both screws after measuring.Screws had good to finger bite.Remove the guidewires) depuy synthes products used: catalog number: 04.233.140s lot number: 9768p16 component type: rfna description: retrograde femoral nail advanced: 11mm: length 400mm.Catalog number: no information provided.Lot number: no information provided.Component type: locking screws.Description: no information provided.Catalog number: no information provided.Lot number: no information provided.Component type: locking screws.Description: no information provided.Catalog number: no information provided.Lot number: no information provided.Component type: locking screws.Description: no information provided.Catalog number: no information provided.Lot number: no information provided.Component type: locking screws.Description: no information provided.Catalog number: no information provided.Lot number: no information provided.Component type: locking screws.Description: no information provided.Catalog number: no information provided.Lot number: no information provided.Component type: locking screws.Description: no information provided.Catalog number: no information provided.Lot number: no information provided.Component type: plate(s).Description: no information provided.
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: d4: udi: as the lot number for the device involved in the event was not provided, the full udi is currently not available.
Additional Manufacturer Narrative
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.

• Brand Name: RFNA/ 11MM/ 400MM/ STANDARD BEND/ STER
• Common Device Name: ROD, FIXATION, INTRAMEDULLARY AND ACCESSORIES
• Manufacturer (Section D): SYNTHES GMBH; luzernstrasse 19-21; zuchwil 4528 ; SZ 4528
• 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 Key: 22825991
• Report Number: 8030965-2025-08476
• Device Sequence Number: 15833311
• Product Code: HSB
• UDI-Device Identifier: 10886982290687
• UDI-Public: (01)10886982290687
• Combination Product (Y/N): N
• Initial Reporter Country: US
• PMA/510(K) Number: K201346
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2024
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Study,Health Professional
• 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?: Yes
• Is this a Product Problem Report?: No
• Operator of Device: Health Professional
• Device Catalogue Number: 04.233.140S
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 07/28/2025
• Supplement Date Received by Manufacturer: 08/19/2025; 09/03/2025
• Initial Report FDA Received Date: 08/18/2025
• Supplement Report FDA Received Date: 08/19/2025; 09/04/2025
• Was Device Evaluated by Manufacturer? (Y/N): No
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Age: 72 YR
• Patient Sex: Female
• Patient Weight: 90 KG
• Patient Race: White