FDA Adverse Event Malfunction Summary report: N

BIOSTEON WEDGE INTERFERENCE SCREW

MDR report key: 2783918 · Received October 3, 2012

Report

Report Number
9617083-2012-00028
Event Type
Malfunction
Date Received
October 3, 2012
Date of Event
September 7, 2012
Report Date
October 2, 2012
Manufacturer
BIOCOMPOSITES LTD.
Product Code
HWC
PMA / PMN Number
K0003641
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SUSPECTED ROOT CAUSE: RESISTANCE TO INSERTION WAS VERY HIGH AND THE APPLIED TORQUE EXCEEDED THE TORSIONAL STRENGTH OF THE SCREW.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT DURING A SURGERY, WHILE TIGHTENING, THE SCREW FRACTURED IN THE MIDDLE AND THE THREADED END REMAINED IN THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BIOSTEON WEDGE INTERFERENCE SCREW BONE SCREW HWC BIOCOMPOSITES LTD. 0412PH303

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention