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Model Number 30-2320 |
Device Problem
Difficult to Remove (1528)
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Patient Problems
Foreign Body In Patient (2687); Insufficient Information (4580)
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Event Date 09/01/2022 |
Event Type
malfunction
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Manufacturer Narrative
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The investigation is pending.A follow up report will be submitted upon completion of the investigation.
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Event Description
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It was reported during an acu-loc 2 removal procedure, some 2.3 screws could not be removed because of a "cold melt issue".It was reported all devices were able to be explanted.Attempts to obtain further clarification regarding the event are being made.This report is related to report numbers 3025141-2022-00363, 3025141-2022-00364, and 3025141-2022-00365 for the other 2.3 screws involved in this event.
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Manufacturer Narrative
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Additional information regarding the event and patient status was received on 28 november 2022.The following information was provided by the surgeon: - this removal procedure on 01 september 2022 (event date) was to remove the devices from the patient as the patient is a pilates teacher and explained that in quadruped postures the volar area of the wrist bothered her.In addition, being a young woman with a daily and high-intensity sports activity, the surgeon recommended removing the material to prevent a sports accident from causing a peri-implant fracture in the future.-this removal surgery lasted 20-25 minutes.-a chisel had to be used to remove the screws and part of the volar cortex tore off.- the patient has an intraosseous screw fragment that has not been removed.- the surgeon had to widen the patient's scar and e made some bruises from having to touch/break the bone.- given the aforementioned broken bone, the surgeon advised patient immobilization for 3 weeks (in a normal removal a bandage is left for one week and without restriction of movement).-currently the patient is well and fully reincorporated to her work and sports practice.As a result of this new information h6.Health effect-clinical code (annex e) and health effect-impact code (annex f) were updated.
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Manufacturer Narrative
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Attempts to obtain further clarification regarding the event were made but were unsuccessful.Manufacturing and inspection records were reviewed, and no anomalies were found.The part number 30-2320 screw was returned for evaluation.The product was visually inspected under magnification.Under magnification the batch number was identified as 474473.Upon inspection, the screw was stuck in the acu-loc vdr plate.Additionally, the broken portion of the hex driver was embedded in the hex recess of the screw.On the threaded portion of the screw, there was significant bony ingrowth attached to the bottom of the screw and near the head of the screw on the underside of the plate hole.Due to the embedded hex tip and the bony growth, the screw could not be removed from the plate.When screws are implanted for a period of time, bony ongrowth will adhere to the titanium which will result in an increase in torque necessary to remove the screws.This type of ongrowth was visible on the plate and some screws.Based on the information received and the investigation performed, the root cause of the reported event could not be determined.
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Search Alerts/Recalls
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