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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH 10.5MM REAMER HEAD FOR RIA 2 STERILE

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SYNTHES GMBH 10.5MM REAMER HEAD FOR RIA 2 STERILE Back to Search Results
Catalog Number 03.404.017S
Medical Device Problem Codes Break (1069); Entrapment of Device (1212)
Health Effect - Clinical Code Foreign Body In Patient (2687)
Date of Event 03/18/2026
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.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
 
Event or Problem Description
It was reported that ria head broke during tibial nail case.Head was removed with guide wire but fragments were left.Procedure was successfully completed.
 
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Brand Name
10.5MM REAMER HEAD FOR RIA 2 STERILE
Common Device Name
REAMER
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 wrights lane east
west chester, PA 19380
9083863534
MDR Report Key24792676
Report Number8030965-2026-03151
Device Sequence Number18594368
Product Code HTO
UDI-Device Identifier10886982273949
UDI-Public(01)10886982273949(17)321130(10)3717P37
Combination Product (Y/N)N
Initial Reporter StateCO
Initial Reporter CountryCA
PMA/510(K) Number
K111437
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,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 Number03.404.017S
Device Lot Number3717P37
Was Device Available for Evaluation? No
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 Manufacturer05/15/2026
Initial Report FDA Received Date04/06/2026
Supplement Report FDA Received Date05/15/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/05/2023
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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