FDA Adverse Event Injury Summary report: N

LO-PRO SCRW,TI,3.5MMX 22MM

MDR report key: 20146596 · Received September 5, 2024

Report

Report Number
1220246-2024-07384
Event Type
Injury
Date Received
September 5, 2024
Date of Event
May 3, 2024
Report Date
July 3, 2025
Manufacturer
ARTHREX, INC.
Product Code
HWC
UDI-DI
00888867050488
PMA / PMN Number
K203294
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

INVESTIGATION IS IN PROCESS. A FOLLOW-UP REPORT WILL BE PROVIDED UPON AVAILABILITY OF ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: E4, G3, H3, H6, H10 THE COMPLAINT DEVICE WAS NOT RECEIVED FOR EVALUATION. BASED ON THE PROVIDED INFORMATION, WHICH MAY INCLUDE THE DEVICE (IF AVAILABLE AND RETURNED), PICTURES, VIDEOS, EVENT DESCRIPTIONS, AND ANY ADDITIONAL FIELD DATA, ARTHREX CONCLUDED THAT THE MOST LIKELY CAUSE OF THE REPORTED FAILURE IS USER ERROR. THIS INCLUDES IMPROPER BONE PREPARATION, MISALIGNED INSERTION, AND/OR PRYING OR LEVERING THE DEVICE DURING INSERTION, WHICH RESULTED IN THE DEVICE BREAKING/ AND OR DAMAGED. THE COMPLAINT ALLEGATION WAS CONFIRMED BASED ON THE CUSTOMER'S ATTACHED PICTURE, WHERE THE DEVICES ARE DISPLAYED AND THE LOW PROFILE SCREW IS SHOWN WITH DAMAGE TO THE SCREW'S HEAD.

Description of Event or Problem · 0

ON 8/12/2024, IT WAS REPORTED BY A PATIENT VIA EMAIL THAT A CANCELLOUS COMPRESSION SCREW, BEING USED WITH A TROCAR TIP TO STABILIZE A LISFRANC INJURY, BROKE OFF IN THE FOOT. THE BROKEN FRAGMENTS WERE NOT REMOVED. ON (B)(6) 2024, THE PATIENT REPORTED THAT THE PROCEDURE TOOK PLACE ON (B)(6) 2024 IN WHICH AN AR-8935CL-26 KREULOCK COMPRESSION SCREW, AN AR-8935-22 NON-LOCKING LOW PROFILE SCREW, AN AR-8935CL-32 KREULOCK COMPRESSION SCREW, AND AN AR-8951MR MEDIUM RIGHT LISFRANC PLATE WAS IMPLANTED. ADDITIONALLY, ANOTHER PLATE AND 5 SCREWS WITH UNKNOWN PART NUMBERS WERE ALSO IMPLANTED. DURING THE PROCEDURE, ONE OF THE SCREWS BROKE ABOUT THE FIFTH THREAD DOWN. AT THIS TIME, IT IS UNKNOWN WHICH SCREW BROKE. THE SURGEON DECIDED TO LEAVE THE BROKEN FRAGMENT IN THE PATIENT, AS REMOVING IT WOULD CAUSE MORE HARM. ONCE THE PATIENT WAS HEALED, ON (B)(6) 2024, A SECOND PROCEDURE WAS PERFORMED TO REMOVE BOTH PLATES AND EIGHT SCREWS, EXCEPT THE BODY OF THE PREVIOUSLY BROKEN SCREW. THE PART NUMBER FOR THE TROCAR TIP REMAINS UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2042932 LO-PRO SCRW,TI,3.5MMX 22MM BONE FIXATION SCREW/PLATE HWC ARTHREX, INC. LO-PRO SCRW,TI,3.5MMX 22MM 15110232 00888867050488

Patients

Seq Age Sex Outcome Treatment
1 65 YR Male Other