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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES USA TI PROXIMAL TIBIA LISS PLATE 5 HOLES/140MM-RIGHT; NAIL,FIXATION,BONE

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SYNTHES USA TI PROXIMAL TIBIA LISS PLATE 5 HOLES/140MM-RIGHT; NAIL,FIXATION,BONE Back to Search Results
Catalog Number 422.300
Device Problem Fitting Problem (2183)
Patient Problems Unspecified Infection (1930); No Code Available (3191)
Event Type  Injury  
Manufacturer Narrative
Device was used for treatment, not diagnosis.Unknown when infection began.(b)(4).Original implant date is unknown.Device is not expected to be returned for manufacturer review/investigation.Therapy dates are unknown due to original implant date unknown.(b)(4): during revision surgery, it was discovered that two screws were cold-welded to the plate.The surgeon had to use a carbide drill to remove the screw heads, and a hollow reamer to remove the screw shafts from the bone.Subject device has not been received.Without a lot number, the device history record review and 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.
 
Event Description
It is reported patient was implanted with a proximal tibia less invasive stabilization system (liss) plate and seven (7) screws on an unknown date to repair a right tibia fracture.On unknown date, patient presented to surgeon with exposed hardware where the plate had broken through the patient¿s skin.Surgeon suspects patient had developed a post-operative infection at the implant site, but was prescribed antibiotics prior to the follow up with surgeon.No infection was present at the time of the follow up visit.Patient was returned to surgery on (b)(6) 2016 where surgeon removed all hardware.It was determined patient bone was significantly healed, no additional hardware was implanted.During the revision surgery, it was noted that the two (2) most distal screws had become cold welded to the plate.Surgeon used a carbide drill to remove the screw heads from these two screws, and then used a hollow reamer to remove the screw shafts from patient bone.Removal of the two (2) screws caused a delay of approximately 20 minutes.Procedure was completed successfully with no further harm to patient.This complaint to address the screws cold welded to the plate.Revision due to infection addressed in (b)(4).3 devices in 2 part tabs.Concomitant devices reported: locking screw (partial part number 422.Xxx, lot unknown, quantity 4) screw (partial part number 412.Xxx,lot unknown quantity 1).This report is 1 of 2 for (b)(4).
 
Manufacturer Narrative
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
TI PROXIMAL TIBIA LISS PLATE 5 HOLES/140MM-RIGHT
Type of Device
NAIL,FIXATION,BONE
Manufacturer (Section D)
SYNTHES USA
1302 wrights lane east
west chester PA 19380
Manufacturer Contact
terry callahan
1302 wrights lane east
west chester, PA 19380
6107195000
MDR Report Key5894350
MDR Text Key52721202
Report Number2520274-2016-14304
Device Sequence Number1
Product Code JDS
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K962047
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 08/09/2016
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/22/2016
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number422.300
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Date Manufacturer Received08/22/2016
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Type of Device Usage Unknown
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age70 YR
Patient Weight64
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