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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DePuy Ireland - 3015516266 ATT FB CENTER TIB DRILL POR; Knee Instrument - Drill Bit

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DePuy Ireland - 3015516266 ATT FB CENTER TIB DRILL POR; Knee Instrument - Drill Bit Back to Search Results
Catalog Number 254511182
Medical Device Problem Codes Material Deformation (2976); Unintended Movement (3026)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/03/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during a total knee arthroplasty (tka) the conical drill had a defect on the top connection portion that locks into the hudson adaptor and it wobbled very badly.After the reporter looked at it the reporter noticed it bent and grabbed another tray to complete the prep portion for the tibia on this surgery.
 
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.D4: udi: as the lot number for the device involved in the event was not provided, the full udi is currently not available.
 
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Brand Name
ATT FB CENTER TIB DRILL POR
Common Device Name
Knee Instrument - Drill Bit
Manufacturer (Section D)
DePuy Ireland - 3015516266
loughbeg ringaskiddy co.
cork
EI 
Manufacturer Contact
elba bello
700 orthopaedic dr.
warsaw, IN 46581
+1(908)386-3534
MDR Report Key50849734
Report Number1818910-2026-16331
Device Sequence Number9935861
Product Code HTW
UDI-Device Identifier10603295499220
UDI-Public10603295499220
Combination Product (Y/N)N
Initial Reporter StateMO
Initial Reporter CountryUS
PMA/510(K) Number
Exempt
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
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 Number254511182
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Received by Manufacturer 09/03/2026
Initial Report FDA Received Date09/22/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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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