MAUDE Adverse Event Report: ACUMED, LLC 1.5MM HEX DRIVER TIP, LOCKING GROOVE; ORTHOPEDIC MANUAL SURGICAL INSTRUMENT

Model Number	80-0728
Medical Device Problem Code	Material Fragmentation (1261)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	05/27/2026
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported by a company representative, a 1.5 driver tip broke off in a 2.3 locking screw head.This occured during a primary surgery with no reported delay and the procedure was completed using another driver tip.
Additional Manufacturer Narrative
To date, the device has not returned for evaluation, the root cause has been established through acumed's health hazard evaluation process.Additional reporting on this event will be provided as a follow up report if alternative information becomes available.

• Brand Name: 1.5MM HEX DRIVER TIP, LOCKING GROOVE
• Common Device Name: ORTHOPEDIC MANUAL SURGICAL INSTRUMENT
• Manufacturer (Section D): ACUMED, LLC; 5885 ne cornelius pass road; hillsboro OR 97124
• Manufacturer (Section G): ACUMED LLC; 5885 ne cornelius pass road; hillsboro OR 97124
• Manufacturer Contact: aram tran ; 5885 ne cornelius pass road; hillsboro, OR 97124
• MDR Report Key: 25512999
• Report Number: 3025141-2026-00304
• Device Sequence Number: 18645428
• Product Code: LXH
• UDI-Device Identifier: 10806378044311
• UDI-Public: 10806378044311
• Combination Product (Y/N): N
• Initial Reporter Country: US
• PMA/510(K) Number: K233311
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 06/23/2026

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 Model Number: 80-0728
• Device Lot Number: 377766
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 05/27/2026
• Supplement Date Received by Manufacturer: 06/19/2026
• Initial Report FDA Received Date: 06/15/2026
• Supplement Report FDA Received Date: 06/23/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• 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
• Concomitant Medical Products and Therapy/Usage Dates: 2.3MM LOCKING SCREW
• Patient Age: 72 YR
• Patient Sex: Female
• Patient Weight: 68 KG
• Patient Race: White