Production process analysis: a review of the device history record confirmed that the device was manufactured and tested according to relevant procedures, and shipped according to manufacturer's specifications.User (surgeon and patient) information analysis: patient #(b)(6) index procedure was performed on (b)(6) 2022.On (b)(6) 2023 apifix was notified that patient #(b)(6) is scheduled for removal surgery on (b)(6) 2023 after 'screw pull-out'.On (b)(6) 2023 apifix was notified that the removal surgery took place on (b)(6) 2023.It was confirmed that the lower screw (apifix) pulled out; additionally, inflammation was noted at the area of the ratchet.On (b)(6) 2023 apifix was notified that the implants would not be returning to manufacturer as the hospital is holding them in case the patient asks for them to be returned.Risk assessment: reoperation events are a known risk that was assessed and recorded by the product risk management file.The risk of screw pullout has been assessed and found to be acceptable the current screw pullout rate due to any reason is in line with the rate reported in the literature for this type of complication as described in the company's cer (clinical evaluation report).The risk has been quantified, characterized, and documented as acceptable within a full risk assessment.Apifix is closing this complaint, but will continue to monitor this 'failure mode'; complaint trending will continue to monitor per post marketing surveillance procedure.If any further relevant information is identified, the complaint file will be reopened and a supplemental medwatch will be filed.
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