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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DePuy Mitek LLC US GRYPHON ORTHOCORD; FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE

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DePuy Mitek LLC US GRYPHON ORTHOCORD; FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE Back to Search Results
Catalog Number 210814
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/21/2026
Type of Reportable Event Malfunction
Event or Problem Description
This is report 1 of 4 for (b)(4).It was reported that during an unknown surgery, the suture of a 4.75 healix advance kntlss br device broke off when tightened.An identical device was used and the suture broke off again.A third identical device was used to complete the surgery.It was further reported that when the gryphon p br anchor w/oc device was tightened the suture broke off and an identical device was used to continue the surgery.When the 4.5 healix advance br w/ocord anchor was tightened the anchor broke off.All broken parts were removed.An identical device was used to complete the surgery.There were no reports of injuries, medical intervention or prolonged hospitalization.All available information has been disclosed.
 
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.H11: additional narrative: as of this date, the device has not been returned for evaluation; therefore, the reported condition cannot be confirmed and/or duplicated.
 
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Brand Name
GRYPHON ORTHOCORD
Common Device Name
FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE
Manufacturer (Section D)
DePuy Mitek LLC US
325 paramount drive
raynham MA 02767
Manufacturer Contact
elba bello
325 paramount drive
raynham, MA 02767
+1(908)386-3534
MDR Report Key50951534
Report Number1221934-2026-04498
Device Sequence Number10446800
Product Code MAI
UDI-Device Identifier10886705001286
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K090124
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
Type of Report Initial
Report Date (Section B) 09/30/2026
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 Number210814
Device Lot Number271L700
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/21/2026
Initial Report FDA Received Date09/30/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/26/2024
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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