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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY ORTHOPAEDICS INC US 45 DEG ANGLE DRILL; DRILLS

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DEPUY ORTHOPAEDICS INC US 45 DEG ANGLE DRILL; DRILLS Back to Search Results
Catalog Number 236683000
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/04/2026
Type of Reportable Event Malfunction
Event or Problem Description
The top slide piece was broken off completely.45 deg angle drill (236683000) : side affected: not applicable ## reason product is not available: available.45 deg angle drill (236683000) : lot/batch number: [redacted].Was there any reported patient or user harm? no.Was there a significant delay? no.
 
Additional Manufacturer Narrative
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.
 
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Brand Name
45 DEG ANGLE DRILL
Common Device Name
DRILLS
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 Key25221624
Report Number1818910-2026-08979
Device Sequence Number18594547
Product Code HTW
UDI-Device Identifier10603295120179
UDI-Public(01)10603295120179(10)SO2010623
Combination Product (Y/N)N
Initial Reporter CountryUS
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 Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup,Followup
Report Date (Section B) 05/19/2026
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 Number236683000
Device Lot NumberSO2010623
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 05/05/2026
Supplement Date Received by Manufacturer05/19/2026
05/25/2026
Initial Report FDA Received Date05/19/2026
Supplement Report FDA Received Date05/20/2026
05/25/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/30/2013
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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