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This is report 4 of 4.Correction: h3.Yes.H6.Investigation findings: 3251.Investigation conclusion: 4307, 61.Device evaluation: visual inspection confirms the event.The screw fractured mid shank.Based on wear on the head, screw was not locked down at an extreme angle.This type of fracture has been observed in dynamic testing, in particular in modified set-ups where the load is shifted distally along the shank.This type of loading may occur in screws that are not seated as deep, shifting the load the screw experienced.Review of device history records showed no manufacturing or processing related irregularities.Labeling review: warnings/cautions/precautions: risks identified with the use of these devices, which may require additional surgery, include device component failure, loss of fixation/stabilization, non-union, vertebral fracture, neurological injury, vascular or visceral injury.Possible adverse effects: initial or delayed loosening, disassembly, bending, dislocation, and/or breakage of device components.Postoperative management: the surgeon should instruct the patient regarding amount and time frame after surgery of any weight bearing activity.The increased risk of bending, dislocation, and/or breakage of the implant devices, as well as an undesired surgical result are consequences of any type of early or excessive weight bearing, vibratory motion, fall, jolts or other movements preventing proper healing and/or fusion development.Implant devices should be revised or removed if bent, dislocated, or broken.Immobilization should be considered in order to prevent bending, dislocation, or breakage of the implant device in the case of delayed, mal-union, or non-union of bone.Immobiliz should continue until a complete bone fusion mass has developed and been confirmed.
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