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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES GMBH AIR PEN DRIVE; MOTOR, DRILL, PNEUMATIC

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SYNTHES GMBH AIR PEN DRIVE; MOTOR, DRILL, PNEUMATIC Back to Search Results
Catalog Number 05.001.080
Medical Device Problem Codes Break (1069); Unintended System Motion (1430)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/01/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This report is being submitted pursuant to the provisions of 21 cfr, part 803.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.H10 additional narrative: investigation summary the actual device was returned for evaluation.A visual and functional assessment was performed on the device.The following steps failed: check general function with apd hand switch check speed with tachometer.During the service evaluation the following failures were identified: internal finding : worn motor functional : will not run.Conclusion: failure reported is not confirmed root cause: improper maintenance.
 
Event or Problem Description
It was reported that the air pen drive device did not stop running; the control unit was damaged.It was not reported if the device was used in surgery.It was not reported if there were any delays in a surgical procedure or if a spare device was available.There were no reports of injuries, medical intervention or prolonged hospitalization.All available information has been disclosed.
 
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Brand Name
AIR PEN DRIVE
Common Device Name
MOTOR, DRILL, PNEUMATIC
Manufacturer (Section D)
SYNTHES GMBH
eimattstrasse 3
oberdorf 4436
SZ  4436
Manufacturer (Section G)
SYNTHES PRODUKTIONS GMBH
hauptstrasse 24
waldenburg 4437
SZ   4437
Manufacturer Contact
elba bello
eimattstrasse 3
oberdorf 04436
SZ   04436
9083863534
MDR Report Key25652936
Report Number8030965-2026-06693
Device Sequence Number20309116
Product Code HBB
UDI-Device Identifier07611819830899
UDI-Public(01)07611819830899
Combination Product (Y/N)N
Initial Reporter CountryGM
PMA/510(K) Number
K093361
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility,Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 06/29/2026
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 Number05.001.080
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/24/2026
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/24/2026
Initial Report FDA Received Date06/29/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/12/2008
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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