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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY SPINE INC MONARCH SPINE SYSTEM TORQUE WRENCH-HANDLE

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DEPUY SPINE INC MONARCH SPINE SYSTEM TORQUE WRENCH-HANDLE Back to Search Results
Catalog Number 277040510
Medical Device Problem Codes Break (1069); Device-Device Incompatibility (2919)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/01/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the torque was damaged on an unknown date.The handle doesn't fit with the keys.
 
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: added: d9, h4.H3, h6: the device was received, the investigation is in progress, no conclusion could be drawn at the time of filing this report.If information is obtained that was not available for the initial medwatch, a follow-up medwatch 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, h4, h6: the product was returned to depuy synthes for evaluation.Visual inspection of the returned device found surface of the torque present signs of continuous use, no broken condition was observed.The observed condition was identified as an end of life indicator; damage consistent with repeated use and servicing.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.A dimensional inspection was not performed since it was not applicable to the complaint condition.An interaction was made with the internal mechanisms of the torque wrench and the adaptor vf1030000, it was found that, although sleeve worked fine, the internal pins are jammed into their slots and won't move when the sleeve is actioned, therefore pins were unable to grip onto the adaptor for a functional test.The reported condition was able to be replicated.The overall complaint was confirmed as the observed condition of the torque wrench would have contributed to the complained issue.Based on the investigation findings, the potential cause is traced to end of life, and it has been determined that no corrective and/or preventative action is required.There is no indication that a design or manufacturing issue has caused the reported complaint condition.As part of depuy synthes 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 (dhr): a review of the receiving inspection (ri) for torque wrench, was conducted identifying that lot number km846373 released in one batch.Batch1: lot qty of (b)(4) units are released on jul 24, 2017, with no discrepancies, batch2: lot qty of (b)(4) units were released on oct 4, 2017, with no discrepancies.Supplier: (b)(4).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
MONARCH SPINE SYSTEM TORQUE WRENCH-HANDLE
Common Device Name
WRENCH
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 Key23416607
Report Number1526439-2025-01387
Device Sequence Number10300087
Product Code HXC
UDI-Device Identifier10705034196770
UDI-Public(01)10705034196770(10)KM846373
Combination Product (Y/N)N
Initial Reporter CountryPO
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,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 Number277040510
Device Lot NumberKM846373
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 10/13/2025
Supplement Date Received by Manufacturer11/25/2025
01/05/2026
Initial Report FDA Received Date10/29/2025
Supplement Report FDA Received Date11/26/2025
01/06/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/24/2017
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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