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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH RETENTION PIN FOR SCREWDRIVER W/ Q C -HEX 12MM/SHORT/XL25

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SYNTHES GMBH RETENTION PIN FOR SCREWDRIVER W/ Q C -HEX 12MM/SHORT/XL25 Back to Search Results
Catalog Number 03.045.008
Medical Device Problem Codes Break (1069); Entrapment of Device (1212)
Health Effect - Clinical Code Foreign Body In Patient (2687)
Date of Event 03/10/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during the procedure the threaded tip of the retention pin intended for a 12 mm short hexagonal rapid-anchoring screwdriver snapped off, leaving it lodged inside the screw.The specialist resolved the issue by using another screwdriver, allowing the surgery to finish successfully without patient impact or alteration in surgical times.
 
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.H6: photo investigation: the product was not returned to depuy synthes; however, photos were provided for review.The photo investigation revealed that "03.045.008, retention pin w/quick-coupl hex 12 short "has broken pieces at the tip.The observed condition of the device was consistent with a random component failure that may have been caused by exposure to unintended forces.However the provided evidence was not sufficient to confirm the reported event of "embedded device".Functionality issues cannot be evaluated through a photo investigation.Since the device was not returned, a dimensional inspection cannot be performed.The overall complaint was confirmed as the observed condition of the retention pin w/quick-coupl hex 12 short would contribute to the complained device issue.Based on the investigation findings, the ¿retention pin w/quick-coupl hex 12 short¿ has ¿broken¿ because of unintended force, and 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 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 lot: the device lot number is unknown; therefore, a device history review could not be performed.If the lot/serial number becomes available, the record will be reassessed.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
RETENTION PIN FOR SCREWDRIVER W/ Q C -HEX 12MM/SHORT/XL25
Common Device Name
SCREWDRIVER
Manufacturer (Section D)
SYNTHES GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
Manufacturer (Section G)
MONUMENT
1101 synthes avenue
monument CO 80132
Manufacturer Contact
elba bello
1302 wrights lane east
west chester, PA 19380
9083863534
MDR Report Key24716540
Report Number8030965-2026-02918
Device Sequence Number12259452
Product Code HXX
UDI-Device Identifier07612334167859
UDI-Public(01)07612334167859
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
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 Number03.045.008
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 03/10/2026
Initial Report FDA Received Date03/30/2026
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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