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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: WRIGHT MEDICAL TECHNOLOGY INC ORTHOLOC 3DI PLATING SYSTEM; PLATE, FIXATION, BONE

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WRIGHT MEDICAL TECHNOLOGY INC ORTHOLOC 3DI PLATING SYSTEM; PLATE, FIXATION, BONE Back to Search Results
Model Number 58813516
Device Problems Break (1069); Fracture (1260)
Patient Problems Failure of Implant (1924); Inadequate Osseointegration (2646); Metal Related Pathology (4530)
Event Date 06/20/2022
Event Type  Injury  
Manufacturer Narrative
The device is not available for evaluation as it remains implanted in the patient.A review of the device history is not possible because the lot number was not communicated.Should additional information become available, it will be provided on a supplemental report.Device remains implanted in patient.
 
Event Description
It was reported that the talar components are loose.Has caused significant metallosis in surrounding tissues.At least one of the screws through the plate broke too.Will have to undergo another surgery.
 
Event Description
It was reported that the talar components are loose.Has caused significant metallosis in surrounding tissues.At least one of the screws through the plate broke too.Will have to undergo another surgery.
 
Manufacturer Narrative
Correction h6 results code, conclusion code.The reported event could be confirmed since images of ct scans were provided and matches the alleged failure mode.There are many clinical factors that can affect the results of any surgery, such as surgical technique, pre-operative and post-operative care, the implant, patient pathology and daily activity.A medical professional reviewed the received information and noted the following: ¿the breakage of a screw was reliably assessed on the mpr of the ct-scan.Poor bone quality and incomplete subtalar fusion led to loosening and subsidence of the talar component and unavoidable breakage of a screw.Multiple interventions reflecting the initial complex hindfoot pathology relate to the bone quality.¿ based on investigation, the root cause was attributed to a patient factor related issue.As noted by a medical professional, the failure was caused by poor bone quality and incomplete subtalar fusion.A review of the device history for the reported lot did not indicate any abnormalities.No corrective actions are required at this time.A review of the labeling did not indicate any abnormalities.No indications of material, manufacturing or design related problems were found during the investigation.If the device is returned or if any additional information is provided, the investigation will be reassessed.
 
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Brand Name
ORTHOLOC 3DI PLATING SYSTEM
Type of Device
PLATE, FIXATION, BONE
Manufacturer (Section D)
WRIGHT MEDICAL TECHNOLOGY INC
1023 cherry rd
memphis TN 38117
Manufacturer (Section G)
WRIGHT MEDICAL TECHNOLOGY, INC.
11576 memphis arlington rd
arlington TN 38002
Manufacturer Contact
anna jusinski
325 corporate drive
mahwah, NJ 07430
2018315000
MDR Report Key15041492
MDR Text Key296058427
Report Number3010667733-2022-00247
Device Sequence Number1
Product Code HRS
UDI-Device Identifier00840420113917
UDI-Public00840420113917
Combination Product (y/n)N
Reporter Country CodeAS
PMA/PMN Number
K120359
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 09/23/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Model Number58813516
Device Catalogue Number58813516
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 06/20/2022
Initial Date FDA Received07/18/2022
Supplement Dates Manufacturer Received08/29/2022
Supplement Dates FDA Received09/24/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
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) Required Intervention; Hospitalization;
Patient Age77 YR
Patient SexFemale
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