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The reported event could be confirmed during the investigation.The device inspection revealed the following: the identification of the returned screw could be confirmed based on the catalog # and the lot # marked.The threads of the locking screw are highly worn out and deformed.The damage observed coincides with the event reported.Therefore, it could be confirmed that one locking screw pulled through the plate.Post-operative x-ray images were received for inspection.The plate was used in conjunction with an intramedullary nail to treat a subtrochanteric femoral fracture.This corresponds to the intended use of the implant.However, the plate was also used for femoral neck stabilization, as proximal screws were implanted inside the neck.This is an off-label use, as pangea peripro femoral plates are not intended for this type of fixation.It has been confirmed by r&d that: "the plate is not intended to be used for this indication.Finally was the fixation with just three screws at both ends of the plate not strong enough, which did to the pull out of the screw." based on investigation, the root cause was attributed to an user related issue.The plate was not used as indicated and was implanted with too few screws, which caused a lack of stabilization of the construct and the migration of the one of the proximal locking screws.As a reminder the instructions for use and the operative technique clearly state that: "the licensed healthcare professional (hcp) and operating room team must be thoroughly familiar with the operating technique, the instruments, as well as the range of implants to be applied.Complete information and labeling on these subjects must be readily available at the workplace." "the peripro femur plating system is also contraindicated for femoral neck fractures treated standalone".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 more information is provided, the case will be reassessed.
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