MAUDE Adverse Event Report: SYNTHES GMBH DRIVING CAP; ORTHOPEDIC MANUAL SURGICAL INSTRUMENT

Catalog Number	03.043.028
Medical Device Problem Code	Detachment of Device or Device Component (2907)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	04/12/2026
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.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.H3, h6: the device lot number is unknown, therefore a¿device history review could not be performed.¿ if the lot/serial number becomes available, the record will be re-assessed.The product was not returned to depuy synthes, however photos were received for review.The photo investigation revealed that the weld of the pin was broken.A functional test cannot be performed due to photo evidence, however, the internal components fell apart confirming the complaint condition.Note: a driving cap from family 03.043.028 was evaluated and investigated by r&d.The observed condition of the pin has been previously assessed by materials and testing.Materials and testing provided drafted report that showed some deficiencies in the weld.Conclusion from r&d was that although the weld might not be perfect there must be some significant load leading to the failure of the weld.Materials and testing subsequently performed a finite element analysis to investigate origin of stress at the interface between cross pin and pull button.Analysis showed that strong off axis hammer blows can lead to oscillations in the system that can cause stress that can lead to breakage of the laser weld at the end of the pin and subsequent migration.Surgical technique guide mentions: to use the hammer, attach the driving cap to the insertion handle and secure it by twisting it one quarter turn.Apply light and controlled hammer blows to seat the nail.Notes: the hammer guide may aid in controlling the direction of the hammer blows.Therefore, the hammer guide can be attached to the back end of the drive cap by screwing both parts together.Since the device was not returned, a dimensional inspection cannot be performed.The overall complaint was confirmed as the observed condition of the driving cap would not contribute to the complained device issue.Based on the investigation findings, it has been determined that no corrective and/or preventative action is proposed.There is no indication that a design or manufacturing issue has caused the complaint condition.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.
Event or Problem Description
It was reported that while inserting the tibia nail, the pin came out of the driving cap, and the driving cap came apart.The pin was located on the floor of the operating room.The patient was not impacted.Procedure was successfully completed with no delay due to the reported event.There was no patient status/ outcome / consequences.

• Brand Name: DRIVING CAP
• Common Device Name: ORTHOPEDIC MANUAL SURGICAL INSTRUMENT
• Manufacturer (Section D): SYNTHES GMBH; luzernstrasse 19-21; zuchwil 4528 ; SZ 4528
• Manufacturer (Section G): SYNTHES SELZACH; bohackerweg 5; selzach CO ; SZ
• Manufacturer Contact: elba bello ; 1302 wright lane east; west chester, PA 19380 ; 9083863534
• MDR Report Key: 25068684
• Report Number: 8030965-2026-04181
• Device Sequence Number: 10415213
• Product Code: LXH
• UDI-Device Identifier: 07612334171092
• UDI-Public: (01)07612334171092(10)21616603
• Combination Product (Y/N): N
• Initial Reporter State: UT
• Initial Reporter Country: US
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• 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,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 Number: 03.043.028
• Device Lot Number: 21616603
• 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: 04/20/2026
• Supplement Date Received by Manufacturer: 05/25/2026; 05/26/2026
• Initial Report FDA Received Date: 05/04/2026
• Supplement Report FDA Received Date: 05/27/2026; 05/27/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 04/07/2023
• 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 Number: 1
• Patient Age: 14 YR
• Patient Sex: Unknown