MAUDE Adverse Event Report: SMITH & NEPHEW, INC. SCREW BIOSURE REGENESORB 7MM X 20MM; FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE

Model Number	72204394
Medical Device Problem Code	Break (1069)
Health Effect - Clinical Code	Device Embedded In Tissue or Plaque (3165)
Date of Event	12/14/2022
Type of Reportable Event	Serious Injury
Event or Problem Description
It was reported that during an acl reconstruction (btb-autograft technique) surgery the screw biosure regenesorb broke inside the patient's femur.Approximately 5mm-7mm was removed of the broken screw and the remaining screw was left in place with secure fixation.It is unknown if there was any surgical delay and a backup device was available.No further complications were reported.
Additional Manufacturer Narrative
Internal complaint reference case- (b)(4).
Event or Problem Description
It was reported that during an acl reconstruction (btb-autograft technique) surgery the screw biosure regenesorb broke inside the patient's femur, 5-7 mm was removed of the broken screw with snaps and the remaining screw was left in place with secure fixation.Thesn biosure 6mm was used to prepare the insertion site, and it was clear of debris.No void was left in the patient.The procedure was completed with a non-significant surgical delay and a backup device was available.No further complications were reported.
Additional Manufacturer Narrative
Internal complaint reference: (b)(4).
Additional Manufacturer Narrative
H3, h6: a device deficiency was not identified, and the root cause of the reported event could not be determined since the device was not returned for evaluation.A review of device records showed there were no indications to suggest that the product did not meet manufacturing specifications upon release for distribution.A complaint history review found similar reported events.The instructions for use were 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 and/or harm was documented appropriately, and there were no indications to suggest the anticipated risk is not adequate.A review of the material specifications found that no burrs, cracks, or contamination is allowed.A certification of compliance to material and processing specifications is required.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.If the product associated with this event is returned at a future date, this investigation will be reopened for evaluation.B5.
Event or Problem Description
It was reported that during an acl reconstruction (btb-autograft technique) surgery the screw biosure regenesorb broke inside the patient's femur, 5-7 mm was removed of the broken screw with snaps and the remaining screw was left in place with secure fixation.The biosure 6mm was used to prepare the insertion site, and it was clear of debris.No void was left in the patient.The procedure was completed with a non-significant surgical delay and a backup device was available.No further complications were reported.

• Brand Name: SCREW BIOSURE REGENESORB 7MM X 20MM
• Common Device Name: FASTENER, FIXATION, BIODEGRADABLE, SOFT TISSUE
• 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: 16103819
• Report Number: 1219602-2023-00031
• Device Sequence Number: 3188489
• Product Code: MAI
• UDI-Device Identifier: 00885554036701
• UDI-Public: 00885554036701
• Combination Product (Y/N): N
• Initial Reporter State: CA
• Initial Reporter Country: US
• PMA/510(K) Number: K142948
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2022
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 05/08/2023

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: 08/09/2025
• Device Model Number: 72204394
• Device Catalogue Number: 72204394
• Device Lot Number: 51055740
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 12/15/2022
• Supplement Date Received by Manufacturer: 01/06/2023; 05/04/2023
• Initial Report FDA Received Date: 01/05/2023
• Supplement Report FDA Received Date: 01/11/2023; 05/08/2023
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 08/09/2022
• 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; Required Intervention
• Patient Age: 36 YR
• Patient Sex: Male