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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH MATRIX 90° L-PLATE MED 2+2HO REVERSIBLE; PLATE, BONE

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SYNTHES GMBH MATRIX 90° L-PLATE MED 2+2HO REVERSIBLE; PLATE, BONE Back to Search Results
Catalog Number 04.511.305S
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/15/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during the surgery, the plate was broken off after contouring.Another device was used to complete the surgery.There were no adverse consequences to the patient.
 
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 report, a follow-up report will be filed as appropriate.H11 additional narrative: d4: udi: the expiration date is currently not available.Therefore, the full udi is currently not available.
 
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 (expiration date), d9, h4 corrected: d4 (primary udi) 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
MATRIX 90° L-PLATE MED 2+2HO REVERSIBLE
Common Device Name
PLATE, BONE
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 wright lane east
west chester, PA 19380
9083863534
MDR Report Key24780194
Report Number8030965-2026-03114
Device Sequence Number9925275
Product Code JEY
UDI-Device Identifier10887587023892
UDI-Public(01)10887587023892(17)350401(10)384L847
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K083388
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
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 Number04.511.305S
Device Lot Number384L847
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 03/18/2026
Supplement Date Received by Manufacturer04/28/2026
05/13/2026
Initial Report FDA Received Date04/03/2026
Supplement Report FDA Received Date04/29/2026
05/14/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/02/2025
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)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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