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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH MULTILOC; ROD, FIXATION, INTRAMEDULLARY AND ACCESSORIES

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SYNTHES GMBH MULTILOC; ROD, FIXATION, INTRAMEDULLARY AND ACCESSORIES Back to Search Results
Catalog Number 04.016.039S
Medical Device Problem Code Manufacturing, Packaging or Shipping Problem (2975)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/01/2026
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 report, a follow-up report will be filed as appropriate.H11 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.
 
Event or Problem Description
It was reported that on an unknown date when the 9.5mm right side multiloc prox humerus nail package was opened it was found that a left side nail was packaged in the box but had a right side label.The patient was not affected.There was no patient consequences.
 
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Brand Name
MULTILOC
Common Device Name
ROD, FIXATION, INTRAMEDULLARY AND ACCESSORIES
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 Key24851719
Report Number8030965-2026-03328
Device Sequence Number18374515
Product Code HSB
UDI-Device Identifier10886982089212
UDI-Public(01)10886982089212
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
K103002
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 Number04.016.039S
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 03/24/2026
Supplement Date Received by Manufacturer05/05/2026
Initial Report FDA Received Date04/11/2026
Supplement Report FDA Received Date05/06/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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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