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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY SYNTHES PRODUCTS LLC 5 CM HEAVY DUTY SHORT ATTACHMENT; MOTOR, DRILL, ELECTRIC

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DEPUY SYNTHES PRODUCTS LLC 5 CM HEAVY DUTY SHORT ATTACHMENT; MOTOR, DRILL, ELECTRIC Back to Search Results
Catalog Number SHORT-HD-G1
Medical Device Problem Code Excessive Heating (4030)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/01/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during service and repair pre-testing, it was discovered that the attachment device was heating up.This event did not occur during surgery.There were no reports of injuries, medical intervention or prolonged hospitalization.The exact date of the event was unknown.However, it was reported that the event occurred in january 2026.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.H10 additional narrative: the actual device was returned for evaluation.A visual and functional assessment was performed on the device.The following steps failed: temperature verification.During the service evaluation the following failures were identified: functional : heat conclusion: failure reported is confirmed.The assignable root cause was determined to be due to component failure from wear.
 
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Brand Name
5 CM HEAVY DUTY SHORT ATTACHMENT
Common Device Name
MOTOR, DRILL, ELECTRIC
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 Key24290796
Report Number1045834-2026-00035
Device Sequence Number10381703
Product Code HBC
UDI-Device Identifier00845384016304
UDI-Public(01)00845384016304
Combination Product (Y/N)N
Initial Reporter CountryNL
PMA/510(K) Number
K133604
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) 02/09/2026
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 Catalogue NumberSHORT-HD-G1
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/25/2026
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/02/2026
Initial Report FDA Received Date02/09/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/10/2017
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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