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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC (CHANGZHOU) MEDICAL DEVICES TE T-HANDLE MT25 DRIVER; SCREWDRIVER

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MEDTRONIC (CHANGZHOU) MEDICAL DEVICES TE T-HANDLE MT25 DRIVER; SCREWDRIVER Back to Search Results
Model Number 5597185
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/17/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
Information was received from user facility via manufacturing representative regarding a product identified during an event.It was reported that driver tip sheared off.There is no patient involved in this event.No further complications were reported/anticipated.
 
Additional Manufacturer Narrative
H3:product analysis #(b)(4):part # 5597185;lot # k22l1504 visual and optical inspection confirmed the tip of the t handle driver is broken.The damage to the driver is consistent with overload.Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
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Brand Name
T-HANDLE MT25 DRIVER
Common Device Name
SCREWDRIVER
Manufacturer (Section D)
MEDTRONIC (CHANGZHOU) MEDICAL DEVICES TE
building #3, 11 changjiang nor
changzhou jiangsu,cn
Manufacturer (Section G)
MEDTRONIC (CHANGZHOU) MEDICAL DEVICES TE
building #3, 11 changjiang nor
changzhou jiangsu,cn
Manufacturer Contact
justin ellis
1800 pyramid place
memphis, TN 38132
7635265677
MDR Report Key24069732
Report Number3005677016-2026-00001
Device Sequence Number9350615
Product Code HXX
UDI-Device Identifier00763000584948
UDI-Public(01)00763000584948(11)220810(10)K22L1504
Combination Product (Y/N)N
Initial Reporter StateIN
Initial Reporter CountryUS
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 02/25/2026
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 Model Number5597185
Device Catalogue Number5597185
Device Lot NumberK22L1504
Was Device Available for Evaluation? Device Returned to Manufacturer
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/17/2025
Supplement Date Received by Manufacturer02/13/2026
Initial Report FDA Received Date01/14/2026
Supplement Report FDA Received Date02/25/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/10/2022
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 Reuse
Patient Sequence Number1
Patient SexUnknown
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