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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH SCRDRIVER SHAFT SELF-HOLDING L165 F/STAR; SCREWDRIVER

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SYNTHES GMBH SCRDRIVER SHAFT SELF-HOLDING L165 F/STAR; SCREWDRIVER Back to Search Results
Catalog Number 03.010.151
Medical Device Problem Code Material Twisted/Bent (2981)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
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 medwatch, a follow-up medwatch will be filed as appropriate.D4: udi: as the lot number for the device involved in the event was not provided, the full udi is currently not available.
 
Event or Problem Description
It was reported several devices were not functioning, some broken or stripped.Additional devices were determined to have parts stuck, have foreign material in the handle or other functional issues.These issues did not impact patient outcomes.(b)(4) are related to each other and are created to capture additional ips.
 
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Brand Name
SCRDRIVER SHAFT SELF-HOLDING L165 F/STAR
Common Device Name
SCREWDRIVER
Manufacturer (Section D)
SYNTHES GMBH
luzernstrasse 19-21
zuchwil 4528
SZ  4528
Manufacturer (Section G)
MONUMENT
1101 synthes avenue
monument CO 80132
Manufacturer Contact
elba bello
1302 wright lane east
west chester, PA 19380
9083863534
MDR Report Key24498678
Report Number8030965-2026-02164
Device Sequence Number21466069
Product Code HXX
UDI-Device Identifier10886982067982
UDI-Public(01)10886982067982
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
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 Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
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 Number03.010.151
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/17/2026
Initial Report FDA Received Date03/03/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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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