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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY SPINE INC 4.35MM DOUBLE-LEAD TAP; TAP, BONE

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DEPUY SPINE INC 4.35MM DOUBLE-LEAD TAP; TAP, BONE Back to Search Results
Catalog Number 279702400
Medical Device Problem Codes Break (1069); Entrapment of Device (1212)
Health Effect - Clinical Code Foreign Body In Patient (2687)
Date of Event 01/27/2026
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.Additional narrative: d4: udi: as the lot number for the device involved in the event was not provided, the full udi is currently not available.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
 
Event or Problem Description
It was reported that it was a thoracic fixation with expedium 5.5 system due to a tumor and the surgical plan was for th2 - th6 fixation, but since the 4.35 mm tap broke into the vertebral body during the operation, a th3 - th6 fixation was performed.The broken instrument was left in the vertebral body as the risk of removal was considered greater than leaving it in place, given the proximity to the dura and exiting root and the associated risk of neurological damage.The patient is doing well, as far as her underlying disease allows.
 
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.H11 additional narrative: added: d9, h4.The device was received, the investigation is in progress, no conclusion could be drawn at the time of filing this report.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
 
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: added: d4 lot.Corrected: d4 primary udi number.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
 
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: h3, h6: the product was returned to depuy synthes for evaluation.The depuy synthes team conducted a visual inspection of the returned device.Visual analysis of the returned sample revealed that the threaded tip of the 4.35mm double-lead tap was broken, the fragment was not received.No other issues were identified.The allegation of embedded device was not confirmed as postoperative images to assess the condition were not provided.A dimensional inspection for the 4.35mm double-lead tap was not performed due to post manufacturing damage.The observed condition of the device was consistent with a random component failure that may have been caused by exposure to unintended forces.Properly handling and attention to the approved use of the device diminishes the risk of failure.A functional test was not performed as it is not applicable to the complaint condition.The overall complaint was confirmed as the observed condition of the 4.35mm double-lead tap would contribute to the complained device issue.Based on the investigation findings, it has been determined that no corrective and/or preventative action is proposed.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.There is no indication that a design or manufacturing issue has caused the complaint condition.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.Device history lot: a review of the receiving inspection (ri) for 4.35mm double-lead tap, was conducted identifying that lot number ng147743, was released in one batch.Batch1: lot qty of (b)(4) were released on oct 10, 2024 with no discrepancies.Supplier: (b)(4).As a result, the ri identified no issues during the manufacturing and release of this device that could have contributed to the problem reported by the customer.Device history review: the ri identified no issues during the manufacturing and release of this device that could have contributed to the problem reported by the customer.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
4.35MM DOUBLE-LEAD TAP
Common Device Name
TAP, BONE
Manufacturer (Section D)
DEPUY SPINE INC
325 paramount drive
raynham MA 02767
Manufacturer Contact
elba bello
325 paramount drive
raynham, MA 02767
9083863534
MDR Report Key24327245
Report Number1526439-2026-00156
Device Sequence Number13147126
Product Code HWX
UDI-Device Identifier10705034198590
UDI-Public(01)10705034198590(10)NG147743
Combination Product (Y/N)N
Initial Reporter CountryHU
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,Followup,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 Number279702400
Device Lot NumberNG147743
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 01/29/2026
Supplement Date Received by Manufacturer03/05/2026
03/23/2026
04/07/2026
Initial Report FDA Received Date02/12/2026
Supplement Report FDA Received Date03/12/2026
03/26/2026
04/08/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/10/2024
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 SexFemale
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