FDA Adverse Event Malfunction Summary report: N

LOCKING SCREW 25

MDR report key: 24313151 · Received February 11, 2026

Report

Report Number
1818910-2026-02803
Event Type
Malfunction
Date Received
February 11, 2026
Date of Event
January 26, 2026
Manufacturer
DEPUY IRELAND - 3015516266
Product Code
HSD
UDI-DI
10603295546580
PMA / PMN Number
K212737
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT # (B)(4). 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.

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT # (B)(4). INVESTIGATION SUMMARY: NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. THE PRODUCT INVESTIGATION FOUND NO EVIDENCE SUSPECTING AN ERROR IN THE MANUFACTURING OR MATERIAL THAT WOULD BE A CONTRIBUTING FACTOR IN THE REPORTED ALLEGATION(S). A RECORDS EVALUATION (MRE) WAS NOT PERFORM. AS PART OF OUR COMPANY QUALITY SYSTEM PROCESS, ALL DEVICES ARE MANUFACTURED, INSPECTED, AND DISTRIBUTED TO APPROVED SPECIFICATIONS. ADDITIONAL COMPLAINT INFORMATION MONITORING FOR POTENTIAL SAFETY SIGNALS WILL BE CONDUCTED THROUGH COMPLAINT TRENDING AS PART OF THE POST-MARKET SURVEILLANCE. IF ADDITIONAL INFORMATION IS MADE AVAILABLE, THE INVESTIGATION WILL BE UPDATED AS APPLICABLE. DEVICE HISTORY LOT: THERE IS NO EVIDENCE SUSPECTING AN ERROR IN THE MANUFACTURING OR MATERIAL THAT WOULD BE A CONTRIBUTING FACTOR IN THE REPORTED ALLEGATION(S). A MANUFACTURING RECORDS EVALUATION (MRE) WAS NOT PERFORMED. ADDED: D10 CONCOMITANT.

Description of Event or Problem · 0

SUBJECT ID: (B)(6). STUDY NO: (B)(4). CLINICAL ADVERSE EVENT RECEIVED FOR IMPLANT SHIFT. DEVICE RELATED: CASUAL RELATIONSHIP (HUMERAL STEMLESS IMPLANT: YES). PROCEDURE RELATED: POSSIBLE. DATE OF EVENT: 26 JAN 2026. DATE OF IMPLANT: (B)(6) 2025. DATE OF REVISION: NO INFORMATION PROVIDED. DEVICE LOCATION: RIGHT. TREATMENT/IMPACT: OBSERVATION. DEPUY SYNTHES PRODUCTS USED: CATALOG NUMBER: 550011240. LOT NUMBER: 66451. COMPONENT TYPE: BASEPLATE. DESCRIPTION: INHANCE SHOULDER SYSTEM MODULAR UNITI PLATFORM BASEPLATE SMALL Ø24MM CEMENTLESS. CATALOG NUMBER: 550035600. LOT NUMBER: 237381. COMPONENT TYPE: SCREW. DESCRIPTION: INHANCE SHOULDER SYSTEM CENTRAL SCREW Ø6.0 X 35MM. CATALOG NUMBER: 550310035. LOT NUMBER: 229426. COMPONENT TYPE: SCREW. DESCRIPTION: INHANCE SHOULDER SYSTEM LOCKING SCREW 35MM. CATALOG NUMBER: 550310025. LOT NUMBER: 233600. COMPONENT TYPE: SCREW. DESCRIPTION: INHANCE SHOULDER SYSTEM LOCKING SCREW 25MM. CATALOG NUMBER: 550310035. LOT NUMBER: 223956. COMPONENT TYPE: SCREW. DESCRIPTION: INHANCE SHOULDER SYSTEM LOCKING SCREW 35MM. CATALOG NUMBER: 550540008. LOT NUMBER: 333136. COMPONENT TYPE: GLENOSPHERE. DESCRIPTION: INHANCE SHOULDER SYSTEM GLENOSPHERE Ø40+8MM. CATALOG NUMBER: 520000044. LOT NUMBER: 659883. COMPONENT TYPE: HUMERAL. DESCRIPTION: INHANCE SHOULDER SYSTEM STEMLESS X-LARGE DIAMETER 44MM CEMENTLESS. CATALOG NUMBER: 550000440. LOT NUMBER: 659083. COMPONENT TYPE: SHELL. DESCRIPTION: INHANCE SHOULDER SYSTEM REVERSE HUMERAL SHELL X-LARGE Ø44+0MM. CATALOG NUMBER: 550040104. LOT NUMBER: MI124741. COMPONENT TYPE: LINER. DESCRIPTION: INHANCE SHOULDER SYSTEM REVERSE LINER RETENTIVE X-LINKED VITAMIN E PE Ø40+4MM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
377993 LOCKING SCREW 25 SHOULDER IMPLANT - LOCKING SCREW HSD DEPUY IRELAND - 3015516266 233600 10603295546580

Patients

Seq Age Sex Outcome Treatment
1 69 YR Male CENTRAL SCREW 6.0X35.| GLENOSPHERE 40+8.| LOCKING SCREW 35.| LOCKING SCREW 35.| MOD UNITI CONV BASEPLATE S 24.| REVERSE HUMERAL SHELL XL 44+0.| REVERSE LINER 40+4 R.| STEMLESS XL 44.