MAUDE Adverse Event Report: OBERDORF SYNTHES PRODUKTIONS GMBH TI LOW PROFILE NEURO SCREW SELF-DRILLING 4MM; BONE PLATE

Catalog Number 400.834S

Device Problem Crack (1135)

Patient Problem No Consequences Or Impact To Patient (2199)

Event Date 04/01/2020

Event Type  malfunction  

Manufacturer Narrative

Additional narrative: only event month and year are known.Complainant part is expected to be returned for manufacturer review/investigation but has yet to be received.(b)(6).The investigation could not be completed; no conclusion could be drawn, as no product was received.Based on the information available, it has been determined that no corrective and/or preventative action is proposed.This complaint will be accounted for and monitored via post market surveillance activities.If additional information is made available, the investigation will be updated as applicable.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.

Event Description

Device report from synthes reports an event in (b)(6) as follows: it was reported that on an unknown date, during a closed cranial surgery, when the surgeon attempted to insert the screw, the screws threads were peeled/torn.It was related to different surgeons and different patients, as the hospital could not distinguish the specific information about surgeon, patient and specific event date.New screws were used to complete the surgery.There were no adverse consequences to the patient.Concomitant device reported: screwdriver (part number unknown, lot unknown, quantity 1).This report involves one (1) ti low profile neuro screw self-drilling 4mm.This is report 10 of 10 for (b)(4).

Manufacturer Narrative

Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.Investigation flow: damage.Visual inspection: the cranial-scr plusdrive 1.6 self-drill l4 (p/n: 400.834s, lot #: 5l90129) was returned at cq.Upon visual inspection, the cross-slot feature and threads were found to be visibly damaged/stripped.The cross-slot feature may impact functionality with the mating screwdriver but does not directly affect material strength.Due to the severe cross slot damage, it appears there was an issue with the insertion of the screws.Device failure/defect identified? yes.Dimensional inspection: no dimensional inspection can be performed due to post-manufacturing damage.Document/specification review: based on the date of manufacture, the current and manufactured revision of drawings were reviewed and no issues related to design and manufacturing were observed.Complaint confirmed? yes.Investigation conclusion the overall complaint condition of threads peeled was confirmed for the cranial-scr plusdrive 1.6 self-drill l4 (p/n: 400.834s, lot #: 5l90129) during the investigation as the threads were observed to be deformed.During the investigation, no product design issues or discrepancies were observed that may have contributed to the complaint condition.The investigation found no evidence of a manufacturing defect.Based on the investigation findings, it has been determined that no corrective and/or preventative action is proposed.A root cause could not be determined during an investigation; however, it is possible the damage could be attributed to unintended forces applied to the device.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.H3, h4, h6: a device history record (dhr) review was conducted: this mre review is for sterilization procedure only part: 400.834s, lot: 5l90129, manufacturing site: bettlach, supplier: (b)(4), release to warehouse date: september 03, 2019, expiry date: august 01, 2029.A manufacturing record evaluation was performed for the finished device lot number, and no non-conformances were identified.Non-sterile part was manufactured in monument part: 400.834.05, lot: h837545.Manufacturing location: monument, manufacturing date: feb 21, 2019, part number: 400.834, ti low profile neuro screw self-drilling 4mm, lot number: h837545 (non-sterile), lot quantity: 350.Work order traveler met all inspection acceptance criteria apart.Inspection sheet, inspect dimensional, met all inspection acceptance criteria.Packaging label logs were reviewed and determined to be conforming.This lot met all dimensional, visual and packaging criteria at the time of release with no issues documented during the manufacture that would contribute to this complaint condition.Component part(s) reviewed: part number:21015, tialnbr14.00, lot number: h692284, lot quantity: 1,682 lbs.Certified test report supplied by perryman company dated jul 05, 2018 was reviewed and determined to be conforming.Lot summary report dated jul 16, 2018 met all inspection acceptance criteria.Raw material receiving/putaway checklist met all inspection acceptance criteria.Device history review jul 07, 2020: dhr reviewed.This lot met all dimensional, visual and packaging criteria at the time of release with no issues documented during the manufacture that would contribute to this complaint condition.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.

• Brand Name: TI LOW PROFILE NEURO SCREW SELF-DRILLING 4MM
• Type of Device: BONE PLATE
• Manufacturer (Section D): OBERDORF SYNTHES PRODUKTIONS GMBH; eimattstrasse 3; oberdorf 4436 ; SZ 4436
• MDR Report Key: 10282667
• MDR Text Key: 199249475
• Report Number: 8030965-2020-04883
• Device Sequence Number: 1
• Product Code: JEY
• UDI-Device Identifier: 07611819771468
• UDI-Public: (01)07611819771468
• Combination Product (y/n): N
• PMA/PMN Number: K022012
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: foreign,other
• Type of Report: Initial,Followup
• Report Date: 06/29/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: 400.834S
• Device Lot Number: 5L90129
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 07/17/2020
• Initial Date Manufacturer Received: 06/29/2020
• Initial Date FDA Received: 07/16/2020
• Supplement Dates Manufacturer Received: 08/07/2020
• Supplement Dates FDA Received: 08/11/2020
• Patient Sequence Number: 1
• Treatment: UNK - SCREWDRIVERS