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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH 4.3MM THREADED LCP(TM) DRILL GUIDE; GUIDE, SURGICAL, INSTRUMENT

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SYNTHES GMBH 4.3MM THREADED LCP(TM) DRILL GUIDE; GUIDE, SURGICAL, INSTRUMENT Back to Search Results
Catalog Number 323.042
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/26/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product complaint #(b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803 (and/or part 4, as applicable).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.
 
Event or Problem Description
It was reported that the lcp drill sleeve 5 f/drill bits ø4.3 broke at its tip during a procedure.The breakage occurred when excessive force was applied while sliding the plate using the drill guide.The fragments were promptly removed, and the device was marked for identification and replacement.The event did not result in any adverse effects or discomfort for the specialist, and the surgery was completed successfully without impact to the patient or changes to the surgical schedule.
 
Additional Manufacturer Narrative
Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.If the information is unknown, not available or does not apply, the section/field of the form is left blank.H11 additional narrative: corrected: g1, h4 h6: the product was not returned to depuy synthes, however photos were provided for review.The photo investigation revealed that the tip of the lcp drill sleeve 5 f/drill bits ø4.3 was broken.The observed condition of the device was consistent with a random component failure that may have been caused by exposure to unintended forces as the device was not returned, and as-received condition could not be assessed, a dimensional inspection and document/specification review were not completed.The overall complaint was confirmed as the observed condition of the lcp drill sleeve 5 f/drill bits ø4.3 would have contributed to the complained device issue.Based on the investigation findings, it has been determined that no corrective and/or preventative action is proposed.There is no indication that a design or manufacturing issue has caused the reported complaint condition.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.Device history review part number: 323.042.Lot number: 649p071.Manufacturing site: hägendorf.Release to warehouse date: 14-april-2022.A manufacturing record evaluation was performed for the finished device batch number, and no non-conformances were identified.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
 
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Brand Name
4.3MM THREADED LCP(TM) DRILL GUIDE
Common Device Name
GUIDE, SURGICAL, INSTRUMENT
Manufacturer (Section D)
SYNTHES GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
Manufacturer (Section G)
WERK HAEGENDORF
im bifang 6
haegendorf CO
SZ  
Manufacturer Contact
elba bello
1302 wright lane east
west chester, PA 19380
9083863534
MDR Report Key24305289
Report Number8030965-2026-01441
Device Sequence Number17446874
Product Code FZX
UDI-Device Identifier07611819246607
UDI-Public(01)07611819246607(10)649P071
Combination Product (Y/N)N
Initial Reporter CountryCO
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
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 Number323.042
Device Lot Number649P071
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 01/27/2026
Supplement Date Received by Manufacturer04/24/2026
Initial Report FDA Received Date02/10/2026
Supplement Report FDA Received Date04/27/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured04/14/2022
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 Unknown
Patient Sequence Number1
Patient SexMale
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