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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY ORTHOPAEDICS INC US CANCELLOUS BONE SCREW 6.5X25MM; BONE SCREWS AND PINS : SCREWS

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DEPUY ORTHOPAEDICS INC US CANCELLOUS BONE SCREW 6.5X25MM; BONE SCREWS AND PINS : SCREWS Back to Search Results
Catalog Number 117225000
Medical Device Problem Code Manufacturing, Packaging or Shipping Problem (2975)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/03/2026
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.H11 additional manufacturer narrative: 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 before a total hip arthroplasty surgical procedure, when the surgeon chose to use the cancellous bone screw, the package was found empty.Another package was opened and the surgery was performed successfully.
 
Additional Manufacturer Narrative
Product complaint #(b)(4).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 joint reconstruction, or its employees hat the report constitutes an admission that the product, depuy synthes joint reconstruction, or its employees caused or contributed to the potential event described in this report.H11 additional narrative: added: d9.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.
 
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Brand Name
CANCELLOUS BONE SCREW 6.5X25MM
Common Device Name
BONE SCREWS AND PINS : SCREWS
Manufacturer (Section D)
DEPUY ORTHOPAEDICS INC US
700 orthopaedic drive
warsaw IN 46581 0988
Manufacturer (Section G)
JTE WARSAW MFG SITE
700 orthopaedic drive
warsaw IN 46582
Manufacturer Contact
elba bello
700 orthopaedic dr.
warsaw, IN 46581
9083863534
MDR Report Key24344492
Report Number1818910-2026-03030
Device Sequence Number9541748
Product Code HWC
UDI-Device Identifier10603295007616
UDI-Public(01)10603295007616(17)340531(10)M6750P
Combination Product (Y/N)N
Initial Reporter CountryGR
PMA/510(K) Number
K970929
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,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 Number117225000
Device Lot NumberM6750P
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 02/03/2026
Supplement Date Received by Manufacturer03/04/2026
05/04/2026
Initial Report FDA Received Date02/16/2026
Supplement Report FDA Received Date03/09/2026
05/06/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/19/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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