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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER LEIBINGER FREIBURG BONE SCREWS, CROSS-PIN, DIAM.2.0X12MM, (5/PACKAGE); IMPLANT

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STRYKER LEIBINGER FREIBURG BONE SCREWS, CROSS-PIN, DIAM.2.0X12MM, (5/PACKAGE); IMPLANT Back to Search Results
Catalog Number 50-20412
Device Problems Break (1069); Detachment Of Device Component (1104)
Patient Problem Foreign Body In Patient (2687)
Event Date 08/18/2017
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 procedure when positioning a plate the head of a screw broke off from the screw body during torque/tightening.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 remaining holes on the plate were fastened with additional screws, and the procedure was completed successfully without a delay.No medical intervention and no adverse consequences were reported with this event.
 
Manufacturer Narrative
The reported event could be confirmed.In the related ti 4853/17 it was stated: ¿(¿) one bone screw, cross-pin, 2.0xxxmm broken during surgery, was returned in order to determine the root cause of the failure.The returned screw was examined regarding its dimensions, chemical composition (edx analysis) as well as by light and scanning electron microscopy.The (measurable) dimensions are in accordance with the specification.The chemical composition conforms to the specification - tial6v4 (ti grade 5).The investigation shows that the screw broke as a result of too high torsional forces in forced rupture mode during the insertion.The fracture surface shows the typical flow structures of a ductile torsional breakage.The root cause of the failure could have been a too small diameter, a too low deepness of the pilot hole or a too powerful tightening of the screw.Indications for material or manufacturing related problems were not found in this investigation.¿ no corrective and/or preventive actions are deemed necessary at this time.The complaint is added to the complaint trend.
 
Event Description
It was reported by a company representative that during a procedure when positioning a plate the head of a screw broke off from the screw body during torque/tightening.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 remaining holes on the plate were fastened with additional screws, and the procedure was completed successfully without a delay.No medical intervention and no adverse consequences were reported with this event.
 
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Brand Name
BONE SCREWS, CROSS-PIN, DIAM.2.0X12MM, (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 Key6822336
MDR Text Key83848265
Report Number0008010177-2017-00215
Device Sequence Number1
Product Code JEY
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K022185
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 02/27/2018
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 Number50-20412
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 08/18/2017
Initial Date FDA Received08/25/2017
Supplement Dates Manufacturer Received08/18/2017
Supplement Dates FDA Received02/27/2018
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 Number1
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