MAUDE Adverse Event Report: STRYKER LEIBINGER FREIBURG BONE SCREWS, CROSS-PIN, DIAM.2.0X10MM, (5/PACKAGE); IMPLANT

Catalog Number 50-20410

Device Problems Break (1069); Detachment Of Device Component (1104)

Patient Problem Foreign Body In Patient (2687)

Event Date 12/22/2016

Event Type  malfunction  

Manufacturer Narrative

The device has not yet been received at the manufacturer for testing.An evaluation will be conducted upon receipt of the device, and a follow-up report will be submitted after the quality investigation is complete.

Event Description

It was reported by a company representative that during a surgical procedure the screw head broke off from the screw body when being torqued.The head part of the screw that broke off was recovered, and the remaining part of the screw body was left in the patient bone.The procedure was completed successfully without a delay.No medical intervention and no adverse consequences were reported with this event.

Manufacturer Narrative

The product was returned for investigation and the reported event could be confirmed.The investigation results show that the bone screw, cross-pin, 2.0xxmm broke as a result of too high torsional forces in forced rupture mode during the insertion.The chemical composition conforms to the specification ¿ tial6v4 (ti grade 5).The fracture surface shows the typical flow structures of a ductile torsional breakage.The root cause of the failure could have been (¿) a too low deepness of the pilot hole.Indications for material or manufacturing related problems were not found in this investigation.Therefore no corrective and/or preventive actions are deemed necessary at this time.

Event Description

It was reported by a company representative that during a surgical procedure the screw head broke off from the screw body when being torqued.The head part of the screw that broke off was recovered, and the remaining part of the screw body was left in the patient bone.The procedure was completed successfully without a delay.No medical intervention and no adverse consequences were reported with this event.

• Brand Name: BONE SCREWS, CROSS-PIN, DIAM.2.0X10MM, (5/PACKAGE)
• Type of Device: IMPLANT
• Manufacturer (Section D): STRYKER LEIBINGER FREIBURG; boetzingerstr. 41; freiburg D-791 11
• Manufacturer (Section G): STRYKER LEIBINGER FREIBURG; boetzingerstr. 41; freiburg D-791 11
• Manufacturer Contact: gregory gohl ; boetzingerstr. 41; freiburg D-791-11 ; 76145120
• MDR Report Key: 6229190
• MDR Text Key: 64285413
• Report Number: 0008010177-2017-00007
• Device Sequence Number: 1
• Product Code: JEY
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K022185
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative
• Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date: 07/21/2017

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: 50-20410
• Device Lot Number: UNKNOWN
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Initial Date Manufacturer Received: 12/22/2016
• Initial Date FDA Received: 01/06/2017
• Supplement Dates Manufacturer Received: 12/22/2016
• Supplement Dates FDA Received: 07/21/2017
• Was Device Evaluated by Manufacturer?: No
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1