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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY SYNTHES PRODUCTS LC 11 CM MEDIUM,QD ANGLE ATTACHMENT; MOTOR, DRILL, ELECTRIC

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DEPUY SYNTHES PRODUCTS LC 11 CM MEDIUM,QD ANGLE ATTACHMENT; MOTOR, DRILL, ELECTRIC Back to Search Results
Catalog Number QD11-G1
Medical Device Problem Code Excessive Heating (4030)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/16/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the angle attachment device had an overheating issue.It was not reported if the device was used in a surgical procedure, or if there was patient involvement.It was not reported if there were any delays in the surgical procedure, or if a spare device was available for use.It was not reported if there were any injuries, medical intervention or prolonged hospitalization.The exact date of the event was not reported; however, it was reported that the event occurred in 2026.All available information has been disclosed.If additional information should become available, a supplemental medwatch will be submitted accordingly.
 
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.Device was used for treatment, not diagnosis.If information is obtained that was not available for this medwatch, a supplemental medwatch 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.
 
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.All the pre-repair diagnostic assessment tests passed.During service/repair the following was observed: no defect found.Conclusion: failure reported is not confirmed.Root cause: no problem detected.
 
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Brand Name
11 CM MEDIUM,QD ANGLE ATTACHMENT
Common Device Name
MOTOR, DRILL, ELECTRIC
Manufacturer (Section D)
DEPUY SYNTHES PRODUCTS LC
4500 riverside drive
palm beach gardens FL 33410
Manufacturer Contact
elba bello
4500 riverside drive
palm beach gardens, FL 33410
9083863534
MDR Report Key24178888
Report Number1045834-2026-00027
Device Sequence Number13266031
Product Code HBC
UDI-Device Identifier00845384016380
UDI-Public(01)00845384016380
Combination Product (Y/N)N
Initial Reporter CountryKS
PMA/510(K) Number
K133604
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,User Facility,Company Representative,Distributor
Initial Reporter Occupation Other
Type of Report Initial,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 NumberQD11-G1
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/19/2026
Supplement Date Received by Manufacturer03/03/2026
Initial Report FDA Received Date01/26/2026
Supplement Report FDA Received Date03/12/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured05/09/2019
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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