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U.S. Department of Health and Human Services

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

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DEPUY SYNTHES PRODUCTS LLC 5 CM SHORT ATTACHMENT; MOTOR, DRILL, ELECTRIC Back to Search Results
Catalog Number SHORT-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 evaluation, it was determined that the attachment device heated up.It was reported in the service order that the device was not working well.It was unknown when the event occurred.There were no reports of delays to a surgical procedure.There were no reports of injuries, medical intervention or prolonged hospitalization.The date of event was unknown but was known to have occurred in 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.H11 additional narrative: a visual and functional assessment was performed on the device.The following steps failed: visual assessment.Temperature verification.Vibration assessment.During the service evaluation the following failures were identified: functional: heat.Functional: vibration.Visual: cosmetic damage.Conclusion: ¿ failure reported is confirmed.
 
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Brand Name
5 CM 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 Key24559017
Report Number1045834-2026-00063
Device Sequence Number15660526
Product Code HBC
UDI-Device Identifier00845384016298
UDI-Public(01)00845384016298
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) 03/10/2026
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-G1
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/27/2026
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/03/2026
Initial Report FDA Received Date03/10/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/07/2019
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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