Product complaint # (b)(4).Visual examination of the viper prime cfxfen xtab 7x40mm has exhibited significant signs of clinical use.The lead thread on the tulip's head is torn and the device exhibits severe indentation marks, consistent with the damage occurred while removing the screw.A review of the device history record was conducted.No issues were identified during the manufacturing and release of this product that could have contributed to the problem reported by the customer.All complaint trends will be evaluated as a part of the depuy spine monthly complaint review meeting.With the information provided, a definitive root cause for the torn threads on the viper prime cfxfen xtab 7x40mm cannot be determined.This damage may have occurred due to cross-threading a set screw upon insertion.As there has been no issue identified in the manufacturing or release of the device that could have contributed to the problem reported by the customer and no systemic trends were found, this complaint file will be closed with no further action required.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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(b)(4).With the information provided, a definitive root cause for the torn threads on the viper prime cfxfen xtab 7x40mm cannot be determined.However, per the surgical technique guide (stg), the procedural flow after screw insertion goes: rod measurement and delivery, set screw insertion, provisional tightening, final tightening, x-tab removal.Each instrument used in these steps (rod holder, final tightener and tab breaker) has a laser etch band that when aligned with the laser etch band on the x-tabs, visually indicates if the rod and set screw are fully seated in the head.This alignment would not have been possible with the raised saddle (poly cap), and a fully seated set screw should also be confirmed with fluoroscopy, prior to removing the x-tabs.Per the event description, the sheared threads on the screw head was created after rod delivery, set screw tightening, x-tab removal, set screw removal, rod removal, rod replacement and set screw replacement.For standard set screw insertion, reduction threads incorporated into the viper prime implant ensure alignment of the set screw prior to its introduction into the implant head.Any attempts to re-insert the set screw without the presence of the x-tab is not prescribed and can potentially result in damaged threads.
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