FDA Adverse Event Injury Summary report: N

SCREWDRIVER

MDR report key: 17530116 · Received August 12, 2023

Report

Report Number
MW5137036
Event Type
Injury
Date Received
August 12, 2023
Date of Event
March 16, 2021
Report Date
April 27, 2021
Manufacturer
KSI
Product Code
HXX
Report Source
Voluntary report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 0

ON (B)(6) 2021, THE PATIENT UNDERWENT THE REVISION SURGERY. IN THE REVISION, WHEN THE SURGEON WAS REMOVING THE LOCKING SCREW WITH THE SCREWDRIVER {KSI PRODUCT), THE TIP OF THE SCREWDRIVER WAS TWISTED AND BROKEN BECAUSE THE SCREW WAS STUCK INTO THE PLATE HARDLY, AND THE SURGEON COULD NOT REMOVE THE SCREW. INSTEAD OF USING THE SCREWDRIVER, THE SURGEON USED A CARBIDE DRILL BIT, CUT OFF THE PLATE AND SCREW, AND REMOVED THE PLATE. ALTHOUGH THE OPERATION TIME WAS DELAYED AND A SMALL AMOUNT OF METAL POWDER REMAINED, THE SURGERY WAS COMPLETED SUCCESSFULLY (THE DELAY TIME IS UNKNOWN). THE SURGEON COMMENTED THAT FOR SOME REASON, THE PLATE AND THE SCREW WERE FIRMLY FIXED, BUT IT WAS THE FIRST TIME THAT THE FIXATION WAS SO FIRM THAT THE SCREWDRIVER WAS TWISTED. (B)(4). THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2)

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1073979 SCREWDRIVER SCREWDRIVER HXX KSI

Patients

Seq Age Sex Outcome Treatment
1 Unknown