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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY ORTHOPAEDICS INC US GLOBAL FX; EXTREMITY INSTRUMENTS : IMPACTION INSTRUMENTS

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DEPUY ORTHOPAEDICS INC US GLOBAL FX; EXTREMITY INSTRUMENTS : IMPACTION INSTRUMENTS Back to Search Results
Catalog Number 212801020
Medical Device Problem Code Break (1069)
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 the global advantage broach handle and metal extraction tip broke during extraction.There was a ten (10) minute surgical delay.The procedure was completed successfully.There were no patient consequences.
 
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.
 
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Brand Name
GLOBAL FX
Common Device Name
EXTREMITY INSTRUMENTS : IMPACTION INSTRUMENTS
Manufacturer (Section D)
DEPUY ORTHOPAEDICS INC US
700 orthopaedic drive
warsaw IN 46581 0988
Manufacturer Contact
elba bello
700 orthopaedic dr.
warsaw, IN 46581
9083863534
MDR Report Key24874831
Report Number1818910-2026-06835
Device Sequence Number21070808
Product Code LXH
UDI-Device Identifier10603295088028
UDI-Public(01)10603295088028(10)AH0800
Combination Product (Y/N)N
Initial Reporter CountryAS
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,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 Number212801020
Device Lot NumberAH0800
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 03/24/2026
Supplement Date Received by Manufacturer06/03/2026
06/16/2026
Initial Report FDA Received Date04/14/2026
Supplement Report FDA Received Date06/04/2026
06/17/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/15/2000
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 Initial
Patient Sequence Number1
Patient SexUnknown
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