MAUDE Adverse Event Report: BIOMET MICROFIXATION 1.5 LACTOSORB SYSTEM 1.5 X 5 MM LACTOSORB SCREW; PLATE, BONE

Model Number	N/A
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	03/17/2021
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Zimmer biomet complaint (b)(4).The device will not be returned for analysis as it was discarded; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental medwatch 3500a will be submitted.Multiple mdr reports were filed for this event, please see associated reports: 0001032347-2021-00169, 0001032347-2021-00170, 0001032347-2021-00171, 0001032347-2021-00172, 0001032347-2021-00173.Concomitant medical products: 1.5 lactosorb system 1.5 x 5 mm lactosorb screw, part# 915-2316, lot# 595560, 1.5 lactosorb system 1.5 x 5 mm lactosorb screw, part# 915-2316, lot# 595560, 1.5 lactosorb system 1.5 x 5 mm lactosorb screw, part# 915-2316, lot# 595560, 1.5 lactosorb system 1.5 x 5 mm lactosorb screw, part# 915-2316, lot# 595560, 1.5 lactosorb system 1.5 x 5 mm lactosorb screw, part# 915-2316, lot# 595560.Report source foreign: (b)(6).
Event or Problem Description
It was reported that six (6) screws fractured upon implantation.The screws were used on the infraorbital margin and zygomatic frontal suture.The surgeon thought he was not inserting the screw diagonally because it was the lower edge and the suture.The surgeon also thought it was strange that the event occurred even if the patient¿s bones were hard.The malfunctions caused a delay greater than thirty (30) minutes.No adverse events have been reported as a result of the malfunction.
Additional Manufacturer Narrative
This follow-up report is submitted to relay additional information.No product was returned or pictures provided; visual and dimensional evaluations could not be performed.Review of the device history records identified no deviations or anomalies during manufacturing.A definitive root cause cannot be determined.If any further information is found which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
Event or Problem Description
No further event information is available at the time of this report.

• Brand Name: 1.5 LACTOSORB SYSTEM 1.5 X 5 MM LACTOSORB SCREW
• Common Device Name: PLATE, BONE
• Manufacturer (Section D): BIOMET MICROFIXATION; 1520 tradeport drive; jacksonville FL 32218
• MDR Report Key: 11624599
• Report Number: 0001032347-2021-00174
• Device Sequence Number: 3020986
• Product Code: JEY
• UDI-Device Identifier: 00841036055196
• UDI-Public: (01)00841036055196(17)250623(10)595560
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• PMA/510(K) Number: K002083
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: distributor,foreign,health pr
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date (Section B): 10/22/2021

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
• Operator of Device: Health Professional
• Device Expiration Date: 06/23/2025
• Device Model Number: N/A
• Device Catalogue Number: 915-2316
• Device Lot Number: 595560
• Was Device Available for Evaluation?: No
• Was the Report Sent to FDA?: No
• Initial Date Received by Manufacturer: 03/18/2021
• Supplement Date Received by Manufacturer: 10/14/2021
• Initial Report FDA Received Date: 04/06/2021
• Supplement Report FDA Received Date: 10/22/2021
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• If action reported to FDA under 21 USC 360i(g), list FDA-assigned Recall Number or include a statement: N/A
• Patient Sequence Number: 1