BEUDAMED
    FDA Adverse Event Injury Summary report: N

    5.0MM TI LOCKING SCREW SELF-DRILLING 26MM

    MDR report key: 2924435 · Received January 22, 2013

    Report

    Report Number
    2520274-2013-00515
    Event Type
    Injury
    Date Received
    January 22, 2013
    Report Date
    December 27, 2012
    Manufacturer
    SYNTHES USA
    Product Code
    HWC
    PMA / PMN Number
    K963325
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS THE PRODUCT IS ENTERING THE COMPLAINT SYSTEM. WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED.

    Additional Manufacturer Narrative · 1

    A MANUFACTURING EVALUATION WAS CONDUCTED. THREE UNKNOWN LOCKING HEAD SCREWS ARE STILL BLOCKED IN THE PLATE NEVERTHELESS, THEIR HEADS ARE DRILLED OUT AND DAMAGED COMPLETELY. DUE TO THE DAMAGE THE COMPLAINT RELEVANT DIMENSIONS CANNOT BE CHECKED TO POST-MANUFACTURING DIMENSIONS ANYMORE. THE LOT NUMBER IS UNKNOWN, HENCE REVIEWING OF MANUFACTURING RECORDS IS NOT POSSIBLE. THIS COMPLAINT IS DEEMED INDETERMINATE FROM A MANUFACTURING STANDPOINT.

    Additional Manufacturer Narrative · 1

    (B)(4): COLD WELDED, GALLED, STUCK SCREWS CAN BE AN ISSUE WITH TITANIUM PLATES AND SCREWS. THIS ISSUE HAS BEEN STUDIED NUMEROUS TIMES INTERNALLY AND WITHIN THE PEER REVIEWED LITERATURE WITH MIXED BELIEFS AS TO THE CAUSE. ONE IS THAT DURING SCREW INSERTION, THE SCREWS ARE OVER TORQUED CAUSING A GALLING SITUATION AND THE OTHER IS THAT BIO INTEGRATION, BONE IN-GROWTH, PROTEIN BRIDGING, CAN CAUSE THE SCREWS TO STICK. THE DESIGN RISK ASSESSMENT IS ADEQUATE FOR THE INTENDED USE. (B)(4): PLACEHOLDER.

    Description of Event or Problem · 1

    PATIENT IMPLANTED WITH LEFT PROXIMAL TIBIA LISS PLATE FIXATION ON (B)(6) 2012 RETURNED TO THE SURGEON COMPLAINING ABOUT THE PLATE PROTRUDING THROUGH THE SKIN. REPORTEDLY, AN EXAM ON UNKNOWN DATE INDICATED FRACTURE WAS HEALED. SURGEON RETURNED THE PATIENT TO THE O.R. ON (B)(6) 2012 FOR REMOVAL OF THE LISS PLATE AND SCREWS. DURING THE REMOVAL, IT WAS FOUND THAT FOUR OF THE SCREWS HAD BECOME COLD-WELDED TO THE PLATE. THE SURGEON BROKE THREE SCREWDRIVERS, TWO CONICAL EXTRACTION SCREWS AND ONE T-HANDLE IN TRYING TO REMOVE THE COLD-WELDED SCREWS. SURGEON HAD TO DRILL OUT THE FOUR SCREWS TO REMOVE THE PLATE. ALL SCREW SHAFT FRAGMENTS WERE CONFIRMED AS RETRIEVED. OTHER SCREWS IN THE PLATE WERE REMOVED WITHOUT DIFFICULTY. THE SURGEON COMPLETED THE PROCEDURE, AND THE PATIENT IS REPORTEDLY RECOVERING WELL. THIS IS 2 OF 10 REPORTS FOR THE SAME EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    29583 5.0MM TI LOCKING SCREW SELF-DRILLING 26MM LOCKING SCREW HWC SYNTHES USA

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Required Intervention PLATE, SCREWS