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