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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH RECIPROCATING SAW ATCH FOR PEN DRIVE; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE

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SYNTHES GMBH RECIPROCATING SAW ATCH FOR PEN DRIVE; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE Back to Search Results
Catalog Number 05.001.040
Medical Device Problem Code Excessive Heating (4030)
Health Effect - Clinical Code Burn(s) (1757)
Date of Event 12/12/2025
Type of Reportable Event Malfunction
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.H10 additional narrative: as of this date, the device has not been returned for evaluation; therefore, the reported condition cannot be confirmed and/or duplicated.
 
Event or Problem Description
This is report 2 of 3 of the same event: it was reported that during an unspecified surgical procedure the electric pen drive device burned a patient during use.It was reported that the device was used with reciprocating saw and drill attachment devices.It was not reported if there were any delays in the surgical procedure or if a spare device was available for use.Patient involvement and injury were reported.However, it is unclear whether any medical intervention was provided or if prolonged hospitalization was required as a result of this event.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: investigation summary.This device was returned for evaluation.A visual and functional assessment was performed on the returned device.No issues were identified with the device.All the pre-repair diagnostic assessment tests passed.During service/repair the following were observed: attachment passed all pre-repair diagnostic assessment.Attachment tested worked within specification.During service/repair the following was observed: no defect found.Conclusion: failure reported is not confirmed.Root cause: no failure found.
 
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Brand Name
RECIPROCATING SAW ATCH FOR PEN DRIVE
Common Device Name
DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE
Manufacturer (Section D)
SYNTHES GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
Manufacturer Contact
elba bello
eimattstrasse 3
oberdorf 04436
SZ   04436
9083863534
MDR Report Key23896122
Report Number8030965-2025-12977
Device Sequence Number14788471
Product Code ERL
UDI-Device Identifier07611819167902
UDI-Public(01)07611819167902(10)268L346
Combination Product (Y/N)N
Initial Reporter CountryAS
PMA/510(K) Number
K043310
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 12/26/2025
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 Number05.001.040
Device Lot Number268L346
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/15/2025
Supplement Date Received by Manufacturer02/03/2026
Initial Report FDA Received Date12/26/2025
Supplement Report FDA Received Date02/03/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/20/2024
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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