FDA Adverse Event
Malfunction
Summary report: N
GSOURCE
MDR report key: 23419729
·
Received October 29, 2025
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Report
- Report Number
- 2249529-2025-00005
- Event Type
- Malfunction
- Date Received
- October 29, 2025
- Date of Event
- August 19, 2025
- Report Date
- October 29, 2025
- Manufacturer
- GSOURCE, LLC.
- Product Code
- HTW
- UDI-DI
- 00840314246554
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- NURSE
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
THE FOLLOWING DETAILS THE INVESTIGATION OF BREAKAGES OF DRILL BIT SQC 2.0MM 125/21.5MM. AFTER COMMUNICATING WITH THE HEALTHCARE PROFESSIONAL, THE LOT NUMBER OR COMPLAINT PART WERE NOT AVAILABLE. BASED ON LITERATURE, THE SMALLER DRILL BIT SIZE IS NOT RECOMMENDED FOR USE IN TOTAL HIP ARTHROPLASTY PROCEDURES. BASED ON INTERNAL TESTING IT DOES NOT APPEAR TO BE A PRODUCT DESIGN RELATED ISSUE. HOWEVER, THE DESIGN WAS IMPROVED TO MAKE IT MORE ROBUST.
Description of Event or Problem · 0
A DRILL BIT BROKE WHILE PERFORMING A TOTAL HIP ARTHROPLASTY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2686846 | GSOURCE | DRILL BIT SQC 2.0MM 125/21.5MM | HTW | GSOURCE, LLC. | GS 86.8221 | 00840314246554 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 76 YR | Female |