FDA Adverse Event Malfunction Summary report: N

TI USS LOW PROFILE FRACTURE CLAMP

MDR report key: 4875748 · Received June 29, 2015

Report

Report Number
2520274-2015-14707
Event Type
Malfunction
Date Received
June 29, 2015
Report Date
June 16, 2015
Manufacturer
SYNTHES MEZZOVICO
Product Code
NKB
PMA / PMN Number
PK082572
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

MANUFACTURING INVESTIGATION EVALUATION: THE RETURNED PARTS WERE RETURNED NOT IN THE ORIGINAL NOT STERILE PACKAGING. SOME VISIBLE POST-PRODUCTION DAMAGES WERE PRESENT ON THE RETURNED ITEMS. THE PARTS HAVE BEEN RE-INSPECTED FOR ALL THE FEATURES PERTINENT TO THE COMPLAINT CONDITION. CONSIDERING THAT ALL RELEVANT MEASURABLE PRODUCT FEATURES MEET SPECIFICATIONS, NO VISUAL DEFECTS HAVE BEEN IDENTIFIED AS MANUFACTURING RELATED. INSPECTION OF THE RELEVANT THREADS OF THE COMPLAINED COMPONENT CANNOT BE PERFORMED DUE TO POST-PRODUCTION DAMAGES. THE SCREWS OF ALL RETURNED PARTS SHOW WEAR ON THE TIP, SUGGESTING THAT THEY CAME IN CONTACT WITH THE ROD. THE EXAGONAL HEAD OF THE RETURNED SCREWS SHOW WEAR AND DAMAGE CAUSED POST-PRODUCTION SUGGESTING EXPOSURE TO HIGH FORCES. NO MANUFACTURING RELATED ISSUES HAVE BEEN IDENTIFIED. DEVICE USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. PATIENT INFORMATION NOT PROVIDED. REPORT IS FOR AN UNKNOWN QUANTITY OF TITANIUM USS FRACTURE CLAMPS ¿ TWO POSSIBLE PART NUMBERS WERE PROVIDED: 498.831 OR 498.833. 510(K) NUMBER FOR P/NS 498.831 AND 498.833 : K082572. WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

ADDITIONAL PRODUCT CODES: MNI, MNH, KWP, KWQ. MANUFACTURING LOCATION: (B)(4). MANUFACTURING DATE: 23JANUARY2015. NO ANOMALIES WERE DETECTED DURING DEVICE HISTORY RECORD REVIEW. NO NON-CONFORMANCE REPORTS WERE GENERATED DURING PRODUCTION. REVIEW OF THE DEVICE HISTORY RECORD SHOWED THAT THERE WERE NO ISSUES DURING THE MANUFACTURE OF THE PRODUCT THAT WOULD CONTRIBUTE TO THIS COMPLAINT CONDITION. THE DEVICE WAS RECEIVED, THE INVESTIGATION COULD NOT BE COMPLETED, AND NO CONCLUSION COULD BE DRAWN, AS PRODUCT IS ENTERING THE COMPLAINT SYSTEM. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

THIS IS REPORT 1 OF 3 FOR (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED DURING A L2 TRAUMA FRACTURE PROCEDURE, THE SURGEON WAS INSERTING THE CLAMP FOR DISTRACTION AT L2. REPORTEDLY THE SURGEON CLAIMS THAT THE GOLD BOLT ON THE TITANIUM USS FRACTURE CLAMPS (498.831 OR 498.833) CONTINUES TO STRIP AFTER HIS FIRST ATTEMPT OF ¿WHITE KNUCKLE¿ TIGHTENING. THE SURGEON REPORTED THAT THIS HAS OCCURRED IN BACK TO BACK CASES WHILE THE SURGEON IS DISTRACTING. REPORTEDLY THE SURGEON WAS ABLE TO REMOVE THE CLAMP, SELECT A NEW CLAMP AND COMPLETE THE PROCEDURE WITH NO FURTHER PROBLEMS. THERE WAS A 20 MINUTE DELAY TO THE SURGERY. SURGEON INSERTED SCREWS TWO LEVELS ABOVE AND BELOW L2. THE SURGEON WOULD LIKE TO KNOW MANUFACTURING DIFFERENCE OF THE CLAMP PRE/POST-MERGER AS HE HAS USED THIS SYSTEM FOR 20+ YEARS AND HAVE NEVER EXPERIENCED THIS TROUBLE UNTIL RECENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
418951 TI USS LOW PROFILE FRACTURE CLAMP ORTHOSIS, SPINAL PEDICLE FIXATION, FOR DDD NKB SYNTHES MEZZOVICO 9340956

Patients

Seq Age Sex Outcome Treatment
1