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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY SYNTHES PRODUCTS LLC MOTOR ASSEMBLY, XMAX; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE

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DEPUY SYNTHES PRODUCTS LLC MOTOR ASSEMBLY, XMAX; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE Back to Search Results
Catalog Number XMAX
Medical Device Problem Codes Leak/Splash (1354); Complete Loss of Power (4015)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during service and evaluation, it was determined that the motor device hose was damaged and was leaking a liquid.The device also failed pretests for hose assessment and oil leak assessment.It was reported in the service order that the device did not function.It was unknown when the event occurred.There were no reports of delays to a surgical procedure.There were no reports of injuries, medical intervention or prolonged hospitalization.The date of event was unknown.All available information has been disclosed.
 
Additional Manufacturer Narrative
This report is being submitted pursuant to the provisions of 21 cfr, part 803.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 narrative: a visual and functional assessment was performed on the device according to n01.32a rev ad.The following steps failed: 4.3.3 hose assessment 4.3.14 oil leak assessment during the service evaluation the following failures were identified: functional: hose damage (excluding rupture) functional: leak - liquid conclusion: failure reported is not confirmed.
 
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Brand Name
MOTOR ASSEMBLY, XMAX
Common Device Name
DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE
Manufacturer (Section D)
DEPUY SYNTHES PRODUCTS LLC
4500 riverside drive
palm beach gardens FL 33410
Manufacturer Contact
elba bello
4500 riverside drive
palm beach gardens, FL 33410
9083863534
MDR Report Key23656937
Report Number1045834-2025-00637
Device Sequence Number14658783
Product Code ERL
UDI-Device Identifier00845384006626
UDI-Public(01)00845384006626
Combination Product (Y/N)N
Initial Reporter CountrySZ
PMA/510(K) Number
K965080
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility,Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 11/26/2025
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 NumberXMAX
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/11/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/18/2025
Initial Report FDA Received Date11/26/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/28/2016
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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