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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITH & NEPHEW, INC. TWINFIX ULTRA PK 5.5MM W/ 2 UB-BL &BLK; FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE

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SMITH & NEPHEW, INC. TWINFIX ULTRA PK 5.5MM W/ 2 UB-BL &BLK; FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE Back to Search Results
Catalog Number 72202625
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Cyst(s) (1800); Pain (1994)
Event Date 03/21/2019
Event Type  Injury  
Event Description
It was reported that a rotator cuff surgery was performed in "2103." mri was performed on the shoulder because pain was reported, there was cysts around one and possibly two of the anchors.S.A.D was performed but the product was not removed from the patient.Device will not be returned.
 
Manufacturer Narrative
Ocurrence date was 2013 instead of 2103.
 
Manufacturer Narrative
One (b)(4) twinfix ultra pk 5.5mm suture anchor reported on.Product was not returned for evaluation.Due to unavailability, the allegation could not be fully confirmed.Definitive conclusions, investigation and evaluation were not possible without physical evaluation.If objective evidence becomes available to assist with evaluation, the complaint will be revisited.Factors that may affect device performance include: device storage, device ability, surgical ability, procedure location and tissue condition.Influences that could compromise product performance or integrity include: 10) alternate prep method, instruments or method used.11) incompatible or unexpected bone density/condition.12) incomplete anchor insertion.10) unexpected bone condition/density.11) use of excess torque.12) loss of or lack of axial alignment.Instructions for use are quite specific for this device.Per instructions for use: ¿use of excessive force during insertion can cause failure of the suture anchor or insertion device.If more torque is required to insert the anchor, stop and ensure that the drill bit size and depth are correct.It is the surgeon¿s responsibility to be familiar with the appropriate surgical techniques prior to use of this device.There is no objective evidence to suggest a direct link between the surgical site infection (ssi) and products used during the procedure.Final product met specifications upon release to distribution.
 
Event Description
It was reported that a rotator cuff surgery was performed in 2013.Mri was performed on the shoulder because pain was reported, there was cysts around one and possibly two of the anchors.S.A.D was performed but the product was not removed from the patient.Device will not be returned.
 
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Brand Name
TWINFIX ULTRA PK 5.5MM W/ 2 UB-BL &BLK
Type of Device
FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE
Manufacturer (Section D)
SMITH & NEPHEW, INC.
130 forbes boulevard
mansfield MA 02048
Manufacturer (Section G)
SMITH & NEPHEW, INC.
130 forbes boulevard
mansfield MA 02048
Manufacturer Contact
jim gonzales
7000 west william cannon drive
austin, TX 78735
5123585706
MDR Report Key8449672
MDR Text Key139794941
Report Number1219602-2019-00348
Device Sequence Number1
Product Code MBI
UDI-Device Identifier03596010647535
UDI-Public03596010647535
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K093228
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,Followup
Report Date 05/16/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/25/2019
Is this an Adverse Event Report? Yes
Device Operator Health Professional
Device Expiration Date04/30/2018
Device Catalogue Number72202625
Device Lot Number50462058
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Date Manufacturer Received05/15/2019
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured05/28/2013
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Other;
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