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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: WRIGHTS LANE SYNTHES USA PRODUCTS LLC 5.0MM VARIABLE ANGLE LOCKNG SCREW/SLF-TPNG/STRDRV/70MM; IMPLANT,FIXATION DEVICE, CONDYLAR PLATE

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WRIGHTS LANE SYNTHES USA PRODUCTS LLC 5.0MM VARIABLE ANGLE LOCKNG SCREW/SLF-TPNG/STRDRV/70MM; IMPLANT,FIXATION DEVICE, CONDYLAR PLATE Back to Search Results
Catalog Number 02.231.270
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Non-union Bone Fracture (2369)
Event Type  Injury  
Manufacturer Narrative
Product complaint # (b)(4).Additional product code: hrs hwc.Without a lot number, the device history records review could not be completed as no product was received.The investigation could not be completed, no product was received; no conclusion could be drawn at the time of filing this report.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
It was reported on an unknown date that the patient underwent a right total hip arthroplasty with removal of deep implants.It was reported that on (b)(6) 2019, the patient underwent an open reduction internal fixation right periprosthetic femoral shaft fracture.Discontinued using her walker, was ambulating independently.Unfortunately, she sustained another fall resulting in a distal femoral fracture and appeared to have a stable femoral component.On (b)(6) 2019, patient had periprosthetic femur fracture for an atrophic nonunion.The patient has had a previous it fracture with a dhs removed at the time of the hip surgery.Upon follow-up surgeon noted failure of plate at the fracture site indicative of nonunion.The patient outcome was unknown.This complaint involves eighteen (18) number of devices.This report is for (1) 5.0mm variable angle locking.This report is 2 of 18 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.H6: product was not returned.Based on the information available, it has been determined that no corrective and 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
This report is for one (1) 5.0mm variable angle lockng screw/slf-tpng/strdrv/70mm.
 
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.If the information is unknown, not available or does not apply, the section/field of the form is left blank.A photo investigation was completed: visual analysis of the photo revealed that there was a plate and screw construct implanted in the right femur.The implanted plate and screw construct does not appear to contribute or impact to the complaint condition.With the available information and since the devices do not appear to have any defect or malfunction, a root cause cannot be established.As the device was not returned, an as-received condition could not be assessed, and a dimensional inspection and document/specification review were not completed.As part of depuy synthes quality process, all devices are manufactured, inspected, and released to approved specifications.The overall complaint was confirmed.There is no indication that a design or manufacturing issue has caused the complaint condition and hence the root cause cannot be determined.Based on the investigation findings, it has been determined that no corrective and/or preventative action is proposed.Additional monitoring for any potential safety signals will be conducted through complaint trending and other post-market safety surveillance activities.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
Additional event description: on 10/04/2019, a clinic reported that patient had a recent fall, and sustained a displaced fracture distal tip.Pain level is 4/10.On (b)(6) 2019, progress note reported that a fracture plate at the site of previous fracture.
 
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.If the information is unknown, not available or does not apply, the section/field of the form is left blank.H10: additional narrative: b5, b6 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.
 
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Brand Name
5.0MM VARIABLE ANGLE LOCKNG SCREW/SLF-TPNG/STRDRV/70MM
Type of Device
IMPLANT,FIXATION DEVICE, CONDYLAR PLATE
Manufacturer (Section D)
WRIGHTS LANE SYNTHES USA PRODUCTS LLC
1302 wrights lane east
west chester PA 19380
Manufacturer (Section G)
WERK MEZZOVICO (CH)
via cavazz 5
mezzovico 6805
SZ   6805
Manufacturer Contact
kara ditty-bovard
1302 wright lane east
west chester, PA 19380
6107195000
MDR Report Key12307577
MDR Text Key266022275
Report Number2939274-2021-04593
Device Sequence Number1
Product Code JDP
UDI-Device Identifier07611819451285
UDI-Public(01)07611819451285
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K110354
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other
Reporter Occupation Other
Type of Report Initial,Followup,Followup,Followup,Followup
Report Date 07/13/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue Number02.231.270
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 07/13/2021
Initial Date FDA Received08/11/2021
Supplement Dates Manufacturer Received09/08/2021
09/08/2021
03/22/2023
04/14/2023
Supplement Dates FDA Received09/08/2021
09/08/2021
04/06/2023
04/19/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Type of Device Usage Unknown
Patient Sequence Number1
Treatment
4.5 THRD CERCLAGE POSITIONING PIN-SILE.; 4.5 THRD CERCLAGE POSITIONING PIN-SILE.; 4.5 VA-LCP CURVED COND PL/16 HOLE/336/RT.; 5.0 VA LCK SCRW/S/TAP /34.; 5.0 VA LCK SCRW/S/TAP /38.; 5.0 VA LCK SCRW/S/TAP /38.; 5.0 VA LCK SCRW/S/TAP /38.; 5.0 VA LCK SCRW/S/TAP /70.; 5.0 VA LCK SCRW/S/TAP /70.; 5.0 VA LCK SCRW/S/TAP /75.; 5.0 VA LCK SCRW/S/TAP /75.; 5.0 VA LCK SCRW/S/TAP /75.; CERCL-CABLE W/CRIMP Ø1.7 SST.; CERCL-CABLE W/CRIMP Ø1.7 SST.; CORTSCR Ø4.5 SELF-TAP L46 SST.; VA LOCKSCR Ø5 SELF-TAP L60.; VA PERIPROSTHETIC LOCK SCREW Ø5 SELF-TAP.; 4.5 THRD CERCLAGE POSITIONING PIN-SILE; 4.5 THRD CERCLAGE POSITIONING PIN-SILE; 4.5 VA-LCP CURVED COND PL/16 HOLE/336/RT; 5.0 VA LCK SCRW/S/TAP /34; 5.0 VA LCK SCRW/S/TAP /38; 5.0 VA LCK SCRW/S/TAP /38; 5.0 VA LCK SCRW/S/TAP /38; 5.0 VA LCK SCRW/S/TAP /70; 5.0 VA LCK SCRW/S/TAP /70; 5.0 VA LCK SCRW/S/TAP /75; 5.0 VA LCK SCRW/S/TAP /75; 5.0 VA LCK SCRW/S/TAP /75; CERCL-CABLE W/CRIMP Ø1.7 SST; CERCL-CABLE W/CRIMP Ø1.7 SST; CORTSCR Ø4.5 SELF-TAP L46 SST; VA LOCKSCR Ø5 SELF-TAP L60; VA PERIPROSTHETIC LOCK SCREW Ø5 SELF-TAP
Patient Outcome(s) Required Intervention;
Patient Age86 YR
Patient SexFemale
Patient Weight61 KG
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