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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH MATNEU SCR Ø1.5 SELF-DRILL L4 TAN; PLATE, CRANIOPLASTY, PREFORMED, ALTERABLE

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SYNTHES GMBH MATNEU SCR Ø1.5 SELF-DRILL L4 TAN; PLATE, CRANIOPLASTY, PREFORMED, ALTERABLE Back to Search Results
Catalog Number 04.503.104.01
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/29/2026
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.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 surgeon went to put in a screw and the screw broke as he completed his last two turns.4mm screw was used.There was no surgical delay due to the reported event and procedure was completed successfully.It is unknown if fragments were generated.There were no patient status/ outcome / consequences.
 
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Brand Name
MATNEU SCR Ø1.5 SELF-DRILL L4 TAN
Common Device Name
PLATE, CRANIOPLASTY, PREFORMED, ALTERABLE
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 Key25200510
Report Number8030965-2026-04639
Device Sequence Number10009983
Product Code GWO
UDI-Device Identifier10887587018324
UDI-Public(01)10887587018324
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
K123723
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 Number04.503.104.01
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 04/29/2026
Supplement Date Received by Manufacturer06/18/2026
Initial Report FDA Received Date05/18/2026
Supplement Report FDA Received Date06/19/2026
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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