FDA Adverse Event Malfunction Summary report: N

ANN BLUNT TIP SCREW 4X48MM

MDR report key: 22587001 · Received July 24, 2025

Report

Report Number
0009613350-2025-00624
Event Type
Malfunction
Date Received
July 24, 2025
Date of Event
July 2, 2025
Report Date
September 12, 2025
Manufacturer
ZIMMER GMBH
Product Code
HSB
UDI-DI
00889024505483
PMA / PMN Number
K231114
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10. ANN BLUNT TIP SCREW 4X50MM ITEM# 47248605040 LOT# 3228024. ANN BLUNT TIP SCREW 4X54MM ITEM# 47248605440 LOT# 3157875. ANN PH NAIL RT 9X160MM ITEM# 47249616009 LOT# 3230675. BLUNT TIP SCREW, ÿ 4X65MM ITEM# 47248606540 LOT# 3197006. CORTICAL BONE SCREW, ÿ 4X30MM ITEM# 47248613040 LOT# 3232072. CORTICAL BONE SCREW, ÿ 4X32MM ITEM# 47248613240 LOT# 3220939. PROXIMAL HUMERUS NAIL CAP, 0MM ITEM# 47248801000 LOT# 3234492. G2. REPORT SOURCE: JAPAN. THE DEVICE WILL NOT BE RETURNED FOR ANALYSIS; HOWEVER, AN INVESTIGATION OF THE REPORTED EVENT IS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

FOLLOW UP REPORT (B)(4). NO PRODUCT WAS RETURNED OR PICTURES PROVIDED; A PRODUCT EVALUATION COULD NOT BE PERFORMED. A REVIEW OF THE DEVICE MANUFACTURING RECORDS CONFIRMED NO ABNORMALITIES OR DEVIATIONS THAT COULD BE RELATED TO THE REPORTED EVENT. REVIEW OF THE COMPLAINT HISTORIES IDENTIFIED ADDITIONAL SIMILAR COMPLAINTS FOR THE REPORTED ITEMS AND THE PART AND LOT COMBINATIONS. COMPLAINTS ARE MONITORED PER COMPLAINT TRENDING PROCESS IN ORDER TO IDENTIFY POTENTIAL ADVERSE TRENDS. AS THE DEVICES INVOLVED IN THE REPORTED EVENT WERE NOT RETURNED FOR INVESTIGATION, A FURTHER PRODUCT EVALUATION COULD NOT BE PERFORMED AND IT IS NOT POSSIBLE TO TEST THE ASSEMBLY OF THE INVOLVED PARTS. IT CAN BE ASSUMED THAT MULTIPLE CONTRIBUTING FACTORS, RELATED TO EITHER PATIENT CONDITION AND BEHAVIOR OR IMPLANTATION PROCEDURE, CONTRIBUTED TO THE MIGRATION OF THE SCREWS. IF AND TO WHAT EXTENT ANY OF THESE ASPECTS MAY HAVE INFLUENCED THE MIGRATION OF THE SCREW REMAINS UNKNOWN. IN CONCLUSION, AS THE CAUSE MAY BE MULTIFACTORIAL, AN EXACT ROOT CAUSE COULD NOT BE IDENTIFIED FOR THE MIGRATION OF THE SCREW. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT AN INITIAL SURGERY WITH ANN NAIL. SUBSEQUENTLY, 9 DAYS POST IMPLANTATION, SURGEON FOUND THREE OF THE PROXIMAL SCREWS WERE BACKED OUT FROM THE PROPER POSITION. THE SURGEON WILL KEEP AN EYE ON THE PATIENT CONDITION AS WELL, AS NO REVISION WILL BE PLANNED SO FAR. DILIGENCE IS COMPLETED AND NO FURTHER INFORMATION ON THE REPORTED EVENT HAS BEEN PROVIDED.

Description of Event or Problem · 0

NO ADDITIONAL EVENT INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1921156 ANN BLUNT TIP SCREW 4X48MM IMPLANT, TRAUMA HSB ZIMMER GMBH 3221188 00889024505483

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown SEE H11 NARRATIVE.