MAUDE Adverse Event Report: SMITH & NEPHEW, INC. SCR BIORCI-HA 9X25 STERILE; SCREW, FIXATION, BONE

Model Number	7207681
Medical Device Problem Codes	Break (1069); Material Deformation (2976)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	09/02/2022
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
Internal complaint reference: (b)(4).
Event or Problem Description
It was reported that during a ligament repair surgery, a biorci-ha´s screw threads were deformed/ broken and that the anchor was slippery and could not be screwed in at all.Surgery resumed after a non-significant delay with a back-up device, used in the originally drilled bone, therefore no voids were left in the patient, whose current health status is good.
Additional Manufacturer Narrative
H10: h2: additional information on b5.H3, h6: the reported device was received for evaluation.There was a relationship found between the device and the reported event.A complaint history review found similar reported events.A review of device records showed there were no indications to suggest that the product did not meet manufacturing specification upon release for distribution.The instructions for use was reviewed and found to include conditions of off label use and technique specifics, as well as precautions and warnings related to the use of the device.A risk management review found that the reported failure was documented appropriately, and there were no indications to suggest the anticipated risk is not adequate.A review of the polymer found that the storage requirements for the material are specified, and the material must comply with provided percentage composition specifications as measured by ash test.A visual inspection of the returned device found that it is not in its original packaging.The distal end of the device is fractured and has biological debris in it.A review of the customer provided images finds the complaint device with the distal end fractured and debris on it.Based on the condition of the product material found during visual inspection, additional material testing is not required.No patient injuries or adverse consequences were reported.Since no patient injuries are being reported no further clinical/medical assessment is warranted at this time.The complaint was confirmed, and the root cause was associated with unintended use of the device.Factors that could have contributed to the reported event include excessive force on the device, excessive torque on the device, attempted correction of a damaged device, off-axis insertion, improper preparation of the insertion site, or an inadvertent impact event inconsistent with normal use.Please refer to the instructions for use for recommendations on proper use of the device and potential troubleshooting methods to prevent future reoccurrence of the reported event.No containment or corrective actions are recommended at this time.H11: h2: correction on h6 (health effect - impact code and medical device problem code).
Event or Problem Description
It was reported that during a ligament repair surgery, a biorci-ha´s screw threads were deformed/ broken and that the anchor was slippery and could not be screwed in at all.It was not necessary to retrieve any part of the device from the patient´s body.Surgery resumed after a non-significant delay with a back-up device, used in the originally drilled bone, therefore no voids were left in the patient, whose current health status is good.

• Brand Name: SCR BIORCI-HA 9X25 STERILE
• Common Device Name: SCREW, FIXATION, BONE
• Manufacturer (Section D): SMITH & NEPHEW, INC.; 130 forbes blvd.; mansfield MA 02048
• Manufacturer (Section G): SMITH & NEPHEW, INC.; 130 forbes blvd.; mansfield MA 02048
• Manufacturer Contact: holly topping ; 7000 west william cannon drive; austin, TX 78735 ; 5123913905
• MDR Report Key: 15470650
• Report Number: 1219602-2022-01433
• Device Sequence Number: 19902162
• Product Code: HWC
• UDI-Device Identifier: 03596010460004
• UDI-Public: 03596010460004
• Combination Product (Y/N): N
• Initial Reporter Country: CH
• PMA/510(K) Number: K002274
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other,Foreign,Consumer,Health Professional,Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 03/09/2023

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
• Operator of Device: Health Professional
• Device Expiration Date: 02/25/2025
• Device Model Number: 7207681
• Device Catalogue Number: 7207681
• Device Lot Number: 50858199
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 09/02/2022
• Supplement Date Received by Manufacturer: 03/08/2023
• Initial Report FDA Received Date: 09/23/2022
• Supplement Report FDA Received Date: 03/09/2023
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 02/25/2020
• 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
• Outcome Attributed to Adverse Event: Other
• Patient Sex: Unknown