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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH DRILL BIT FOR 5.0MM RECON SCREWS/LARGE QC; BIT, DRILL

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SYNTHES GMBH DRILL BIT FOR 5.0MM RECON SCREWS/LARGE QC; BIT, DRILL Back to Search Results
Catalog Number 03.010.228
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/22/2026
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.
 
Event or Problem Description
During the nailing surgery with alfn product, the drill bit of the set broke inside the patient.
 
Event or Problem Description
Additional information received: what do you mean by broken? did it broke into two or more pieces, cracked, bent or any other deficiency with the device that was not function as intended? it broke in 2 pieces.
 
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: b5, h4 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
DRILL BIT FOR 5.0MM RECON SCREWS/LARGE QC
Common Device Name
BIT, DRILL
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 Key25002238
Report Number8030965-2026-03857
Device Sequence Number8750527
Product Code HTW
UDI-Device Identifier07611819307711
UDI-Public(01)07611819307711(10)U351896
Combination Product (Y/N)N
Initial Reporter CountryIT
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 Number03.010.228
Device Lot NumberU351896
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 04/21/2026
Supplement Date Received by Manufacturer05/11/2026
06/05/2026
Initial Report FDA Received Date04/27/2026
Supplement Report FDA Received Date05/14/2026
06/08/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/21/2020
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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