FDA Adverse Event
Injury
Summary report: N
LEVEL ONE
MDR report key: 23010168
·
Received September 9, 2025
Report
- Report Number
- 9610905-2025-00063
- Event Type
- Injury
- Date Received
- September 9, 2025
- Date of Event
- August 11, 2025
- Report Date
- August 11, 2025
- Manufacturer
- KLS MARTIN SE & CO. KG
- Product Code
- HTW
- UDI-DI
- 00888118040985
- PMA / PMN Number
- CLS 1 EXEMPT
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
AN INVESTIGATION WAS SUCCESSFULLY COMPLETED. THE RESULTS OF THE INVESTIGATION HAVE IDENTIFIED NO MANUFACTURING ISSUES, NO DESIGN ISSUES AND/OR CORRECTIVE ACTIONS NECESSARY AT THIS TIME. IF FURTHER INFORMATION IS OBTAINED THAT MIGHT ADD VALUE TO THE CONTENTS OF THE INVESTIGATION REPORT, AN ADDITIONAL FOLLOW-UP REPORT WILL BE SUBMITTED. THE REPORTED RPMS EXCEEDED THE MAXIMUM RECOMMENDED SPEED FOUND IN THE IFU.
Description of Event or Problem · 0
IT WAS REPORTED DURING INITIAL SURGERY A TWIST DRILL FRACTURED DURING USE. A PORTION OF IT REMAINS IMPLANTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2841043 | LEVEL ONE | TWIST DRILL | HTW | KLS MARTIN SE & CO. KG | 25-452-07-91 | UNKNOWN | 00888118040985 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Male | Other |