FDA Adverse Event Malfunction Summary report: N

VA-LCP-2-COLUMN DRP2.4 VOLAR LE SHAFT 2H

MDR report key: 3101719 · Received May 9, 2013

Report

Report Number
2520274-2013-02465
Event Type
Malfunction
Date Received
May 9, 2013
Date of Event
May 15, 2012
Report Date
April 15, 2013
Manufacturer
SYNTHES USA
Product Code
HRS
PMA / PMN Number
K083694
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. THE MANUFACTURING RECORDS WERE REVIEWED AND NO COMPLAINT RELATED ISSUES WERE FOUND. SUBJECT DEVICE HAS BEEN RECEIVED AND IS CURRENTLY IN THE EVALUATION PROCESS. INVESTIGATION IS ON GOING; NO CONCLUSION COULD BE DRAWN.

Additional Manufacturer Narrative · 1

THIS DEVICE USED FOR TREATMENT AND NOT DIAGNOSIS. THE INVESTIGATION OF THE COMPLAINED ARTICLES SHOWS THAT THE LOCKING THREAD AT THE SCREW HEADS IS PARTIALLY BADLY DEFORMED. THIS INDICATES CLEARLY MECHANICAL MISHANDLING DURING USE. IT IS POSSIBLE THAT TOO MUCH APPLIED MECHANICAL FORCE WHILE INSERTION MAY HAVE CAUSED THE DEFORMATIONS. THE PLATE THREADS ARE USED BUT OTHERWISE IN GOOD CONDITION. REVIEWING THE MANUFACTURING- AND MATERIAL DOCUMENTATION OF THE PLATE SHOWS CONFORMITY AS WELL. NO PRODUCT FAULT COULD BE DETECTED.

Description of Event or Problem · 1

DEVICE REPORT FROM SYNTHES (B)(4) REPORTS AN EVENT IN (B)(6) AS FOLLOWS: DURING AN INSERTION OF VARIABLE ANGLE LOCKING SCREWS TO A PLATE, THE TIP OF A SCREW TWISTED. THE SCREWS WERE INSERTED BY HAND. THE PLATE WAS FIXED WITH AN AIMING BLOCK. SIX SCREWS WERE TO BE INSERTED TO THE PLATE, BUT THE SURGEON WAS UNABLE TO FINISH LOCKING IN THE PROXIMAL ROW STYLOID HOLE. AN ADDITIONAL SCREW WAS INSERTED IN THE HOLE AND WAS RUN THROUGH. THE SURGEON REMOVED THE SCREW FROM THE FRACTURE PART OF THE PLATE. THE OPERATION WAS COMPLETED. THIS IS REPORT 2 OF 2 FOR COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
202745 VA-LCP-2-COLUMN DRP2.4 VOLAR LE SHAFT 2H HRS SYNTHES USA 7792429

Patients

Seq Age Sex Outcome Treatment
1