FDA Adverse Event Malfunction Summary report: N

SCRDRIVERSHAFT-CRUCIF 2.4 L100

MDR report key: 3181095 · Received June 20, 2013

Report

Report Number
8030965-2013-03686
Event Type
Malfunction
Date Received
June 20, 2013
Report Date
March 8, 2012
Manufacturer
SYNTHES GMBH
Product Code
HXX
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TC
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL NARRATIVE: SYNTHES IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO FDA WARNING LETTER DATED FEBRUARY 2012. DEVICE(S) LISTED IN THIS REPORT IS (ARE) USED FOR TREATMENT, NOT DIAGNOSIS. ANY ADDITIONAL INFORMATION RECEIVED REGARDING THIS EVENT AFTER FILING THIS REPORT SHALL BE FILED ON A SUPPLEMENTAL MDR. DEVICE IS AN INSTRUMENT AND IS NOT IMPLANTED/EXPLANTED. THE PRESENT SCREWDRIVER WAS ANALYZED FOR CONFORMANCE TO PRINT SPECIFICATIONS AS WELL AS THE DEVICE HISTORY RECORD WAS RESEARCHED;NO ABNORMAL FINDINGS WERE IDENTIFIED. MANUFACTURING AND INSPECTION RECORDS INDICATED NO PROBLEMS WITH THE LOT IN QUESTION. THE FRACTURE FACE OF THE BROKEN TIP IS HOMOGENOUS WHICH INDICATES MATERIAL CONFORMITY. BASED ON THESE FINDINGS WE CONCLUDE THAT THE CAUSE OF FAILURE IS NOT DUE TO ANY MANUFACTURING NON-CONFORMANCES AND WE HAVE TO ASSUME THAT EXCEEDING APPLIED MECHANICAL FORCES LED TO THE BREAKAGE. NOTE THAT THIS IS THE FIRST COMPLAINT WITH THIS ITEM.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING THE FIRST SURGERY WHILE REMOVING A SCREW FROM THE DISTAL RADIUS PLATE, THE TIP BROKE OFF THE SCREW DRIVER HEAD. THE BROKEN PART WAS RETRIEVED AND DISPOSED. THIS IS REPORT 1 OF 1 FOR COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
280031 SCRDRIVERSHAFT-CRUCIF 2.4 L100 HXX SYNTHES GMBH 7721603

Patients

Seq Age Sex Outcome Treatment
1