FDA Adverse Event Malfunction Summary report: N

MECTALIF ANTERIOR MECTALIF ANTERIOR STAND-ALONE SCREW DIAM.5X35 ENHANC

MDR report key: 8764337 · Received July 5, 2019

Report

Report Number
3005180920-2019-00542
Event Type
Malfunction
Date Received
July 5, 2019
Date of Event
June 6, 2019
Report Date
July 30, 2019
Manufacturer
MEDACTA INTERNATIONAL SA
Product Code
OVD
UDI-DI
07630030875434
PMA / PMN Number
K160605
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NZ
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

ON THE 7 JULY 2019 WE RECEIVED THE DATE OF THE PRIMARY SURGERY AND MORE DETAILS ABOUT THE FIRST REVISION PERFORMED FEW DAYS AFTER PRIMARY. ON THE 23 JULY 2019 WE WERE INFORMED THAT THERE ARE NO EVIDENCE OF REVISION SURGERY PERFORMED TO THIS PATIENT.

Description of Event or Problem · 0

SPINE SCREW BREAKAGE AFTER ABOUT 1 YEAR AND 7 MONTHS FROM PRIMARY SURGERY. NO EVIDENCE OF REVISION SURGERY PERFORMED FOR THE MOMENT. THE PATIENT HAD A REVISION SURGERY FEW DAYS AFTER PRIMARY TO PUT L5 ENDPLATE AND TO SHORTEN S1 SCREW SITTING IN THE FORAMEN, THE SURGEON ONLY SWAPPED OUT 1 SCREW AS HE WAS UNHAPPY WITH SIZE HE ORIGINALLY USED. THE PRIMARY SURGERY HAS BEEN PERFORMED ON THE (B)(6) 2017.

Additional Manufacturer Narrative · 1

THE LOT OF THE SCREW BROKEN IS NOT KNOWN FOR THIS WE REPORT THE BATCH REVIEW OF ALL THE SCREW IMPLANTED. BATCH REVIEW PERFORMED ON 02-JULY-2019: MECTALIF ANTERIOR 03.30.115 MECTALIF ANTERIOR STAND-ALONE SCREW DIAM.5.5X25 ENHANCED (K160605) LOT 1621051: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 18-MAY-2017. EXPIRATION DATE: 2022-03-26. NO ANOMALIES FOUND RELATED TO THE PROBLEM. TO DATE, (B)(4) ITEMS OF THE SAME LOT HAVE BEEN ALREADY SOLD WITHOUT ANY OTHER SIMILAR REPORTED EVENT. MECTALIF ANTERIOR 03.30.133 MECTALIF ANTERIOR STAND-ALONE SCREW DIAM.5X35 ENHANCED (DOUBLE PACKAGING) (K160605) LOT 1621048: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 18-MAY-2017. EXPIRATION DATE: 2022-04-03. NO ANOMALIES FOUND RELATED TO THE PROBLEM. TO DATE, (B)(4) ITEMS OF THE SAME LOT HAVE BEEN ALREADY SOLD WITHOUT ANY OTHER SIMILAR REPORTED EVENT. MECTALIF ANTERIOR 03.30.133 MECTALIF ANTERIOR STAND-ALONE SCREW DIAM.5X35 ENHANCED (DOUBLE PACKAGING) (K160605) LOT 1621050: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 27-JULY-2017. EXPIRATION DATE: 2022-07-16. NO ANOMALIES FOUND RELATED TO THE PROBLEM. TO DATE, (B)(4) ITEMS OF THE SAME LOT HAVE BEEN ALREADY SOLD WITHOUT ANY OTHER SIMILAR REPORTED EVENT MECTALIF ANTERIOR 03.30.131 MECTALIF ANTERIOR STAND-ALONE SCREW DIAM.5X25 ENHANCED (DOUBLE PACKAGING) (K160605) LOT 1621051: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 01-SEP-2017. EXPIRATION DATE: 2022-07-16. NO ANOMALIES FOUND RELATED TO THE PROBLEM. TO DATE, (B)(4) ITEMS OF THE SAME LOT HAVE BEEN ALREADY SOLD WITHOUT ANY OTHER SIMILAR REPORTED EVENT CLINICAL EVALUATION PERFORMED BY MEDACTA MEDICAL AFFAIRS DIRECTOR: APPROXIMATELY 1 YEAR AFTER ALIF LUMBAR STABILIZATION, ONE OF THE SCREWS SHEARED OFF JUST BELOW THE HEAD. THIS KIND OF OCCURRENCE MAY INTERVENE WHEN THE EXPECTED FUSION, IN THIS CASE L5-S1, DID NOT OCCUR. WE COULD NOT FIND REPORTS OF CLINICAL PROBLEMS: IF HTE FUSION INTERVENED AFTERWARDS IT IS POSSIBLE THAT NO INTERVENTION IS REQUIRED. THE REPORT DOES NOT SPECIFY HOW, ONG AFTER PRIMARY SURGERY THE SCREW WAS FOUND TO BE BROKEN. WITH THE INFORMATION AT HAND, WE CANNOT DRAW ANY CONCLUSION FOR THE SCOPE OF THE CLINICAL INVESTIGATION.

Description of Event or Problem · 1

SPINE SCREW BREAKAGE AFTER ABOUT 1 YEAR AND 7 MONTHS FROM PRIMARY SURGERY. NO REVISION SURGERY HAS BEEN PERFORMED FOR THE MOMENT. THE PATIENT HAD A REVISION SURGERY FEW DAYS AFTER PRIMARY TO PUT L5 ENDPLATE AND TO SHORTEN S1 SCREW SITTING IN THE FORAMEN. THE DATE OF PRIMARY SURGERY IS UNKNOWN FOR THE MOMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
558641 MECTALIF ANTERIOR MECTALIF ANTERIOR STAND-ALONE SCREW DIAM.5X35 ENHANC SPINE SCREW OVD MEDACTA INTERNATIONAL SA 1621048 07630030875434

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention