FDA Adverse Event Injury Summary report: N

UNKNOWN MINI MONSTER 4MM SCREW

MDR report key: 24856246 · Received April 13, 2026

Report

Report Number
3008650117-2026-00170
Event Type
Injury
Date Received
April 13, 2026
Date of Event
March 4, 2025
Report Date
April 13, 2026
Manufacturer
PARAGON 28
Product Code
HWC
PMA / PMN Number
NI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10: P82-001-1237-SK, R3FLEX IMPLANT W/INSR SK, UNKNOWN LOT. UNKNOWN R3CON LOCKING 3.5X14 MM SCREW X2. UNKNOWN R3CON LOCKING 3.5X16 MM SCREW. UNKNOWN R3CON NON-LOCKING 3.5X12 MM SCREW X3. UNKNOWN R3CON NON-LOCKING 3.5X14 MM SCREW. UNKNOWN MINI MONSTER 4MM SCREW. 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 3500A WILL BE SUBMITTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT APPROXIMATELY 5 MONTHS POST IMPLANTATION OF A LEFT ANKLE STABILIZATION SYSTEM WITH SCREWS, THE PATIENT EXPERIENCED PAIN THAT WAS LIMITING ACTIVITY AND PARTICIPATION IN PT. PATIENT HAS BEEN REFERRED TO A PAIN SPECIALIST TO TREAT SUSPECTED LEFT SAPHENOUS NEURITIS. ATTEMPTS HAVE BEEN MADE AND NO ADDITIONAL INFORMATION HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
922477 UNKNOWN MINI MONSTER 4MM SCREW SCREW, FIXATION, BONE HWC PARAGON 28 NI

Patients

Seq Age Sex Outcome Treatment
1 48 YR Male Other SEE H11 NARRATIVE.