MAUDE Adverse Event Report: LOCKING SCREW, T8 FULL THREAD, 2.4MM/L14MM; PLATE, FIXATION, BONE

Model Number	656014
Medical Device Problem Code	Positioning Failure (1158)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	07/19/2021
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Upon completion of the investigation any additional information will be communicated in a supplemental report.
Event or Problem Description
It was reported that the screw wouldn't lock in the plate, so the surgeon decided to use another screw.The second screw was successful.The failed screw was damaged, but no details about the damage have been provided.The procedure was completed successfully, with no adverse consequences to the patient.No clinically significant delay in treatment has been reported.
Event or Problem Description
It was reported that the screw wouldn't lock in the plate, so the surgeon decided to use another screw.The second screw was successful.The failed screw was damaged, but no details about the damage have been provided.The procedure was completed successfully, with no adverse consequences to the patient.No clinically significant delay in treatment has been reported.
Additional Manufacturer Narrative
D9 / h3 updated to indicate device was not returned.The reported event that an unknown variax2 screw was alleged of issue ¿implant - insertion impaired¿ could not be confirmed, since the device was not returned and as the received picture is not sufficient to make an evaluation.The device inspection was not possible as the product was not returned for investigation.A potential non-conformity report was nonetheless initiated to address this event.The comprehensive root cause analysis of the potential ncr included a surface and microstructure analysis as well as nano-indent hardness measurement of variax1 and variax2 screw samples by the fraunhofer institute on behalf of stryker.Further internal investigation efforts were focusing on the anodization color difference between variax1 and variax2 screws.Significant differences between the screws which could result in the reported complaints have not been revealed in either fraunhofer or stryker investigations.Excessive in-house handling and bench testing with variax2 screws from various manufacturing batches showed that locking is achieved as intended.The desired increase in torque indicating to the customer that the screw is locking in the plate, can be confirmed.Considering the information given and based on the above investigations a root cause of the reported event could not be determined.A review of the device history for the reported lot did not indicate any abnormalities.A review of the labeling did not indicate any abnormalities.If any further substantial information is provided, the investigation report will be updated.H3 other text : device disposition is unknown.

• Brand Name: LOCKING SCREW, T8 FULL THREAD, 2.4MM/L14MM
• Common Device Name: PLATE, FIXATION, BONE
• MDR Report Key: 12333523
• Report Number: 0008031020-2021-00367
• Device Sequence Number: 2825461
• Product Code: HRS
• UDI-Device Identifier: 07613327068344
• UDI-Public: 07613327068344
• Combination Product (Y/N): N
• Initial Reporter Country: CO
• PMA/510(K) Number: K132502
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: company representative
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 10/26/2021

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 Model Number: 656014
• Device Catalogue Number: 656014
• Device Lot Number: 1000438631
• Was Device Available for Evaluation?: No
• Initial Date Received by Manufacturer: 07/23/2021
• Supplement Date Received by Manufacturer: 09/30/2021
• Initial Report FDA Received Date: 08/17/2021
• Supplement Report FDA Received Date: 10/26/2021
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 02/18/2021
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Age: 64 YR
• Patient Weight: 63