MAUDE Adverse Event Report: STRYKER LEIBINGER FREIBURG PLT/FRACTURE 14 HOLES; IMPLANT

Catalog Number	55-15514
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	05/07/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Device is not available for evaluation.If additional information is received, it will be reported on a supplemental report.
Event or Problem Description
It was reported that the patient returned to the hospital with a broken implanted plate.
Event or Problem Description
It was reported that the patient returned to the hospital with a broken implanted plate, resulting in a revision surgery to remove the implants.
Additional Manufacturer Narrative
Additional information: b5, h4, h6.Correction: b2.The reported event could not be confirmed, because neither the products nor any further information could be provided.A review of all relevant manufacturing and inspection records for the reported screws and plate found no issues, and the lots were properly manufactured and accepted into final stock.According to the risk file, such events may result from user-related factors or surgical conditions, including incorrect implant selection, improper assembly or insertion, and patient-specific limitations.Based on the investigation, there is no indication for an incorrectly working product or any design, material, or manufacturing-related issue.Therefore, no corrective and/or preventive actions are deemed necessary at this time.

• Brand Name: PLT/FRACTURE 14 HOLES
• Common Device Name: IMPLANT
• Manufacturer (Section D): STRYKER LEIBINGER FREIBURG; boetzingerstr. 41; freiburg D-791 11; GM D-79111
• Manufacturer (Section G): STRYKER LEIBINGER FREIBURG; boetzingerstr. 41; freiburg D-791 11; GM D-79111
• Manufacturer Contact: elena drewenskus ; boetzingerstr. 41; freiburg D-791-11 ; GM D-79111 ; 7614888208
• MDR Report Key: 22043476
• Report Number: 0008010177-2025-00074
• Device Sequence Number: 9017635
• Product Code: JEY
• UDI-Device Identifier: 04546540356314
• UDI-Public: 04546540356314
• Combination Product (Y/N): N
• Initial Reporter Country: RO
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 08/07/2025

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
• Device Catalogue Number: 55-15514
• Device Lot Number: 1000558256
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Follow-Up
• Initial Date Received by Manufacturer: 05/07/2025
• Supplement Date Received by Manufacturer: 05/07/2025
• Initial Report FDA Received Date: 05/19/2025
• Supplement Report FDA Received Date: 08/07/2025
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 04/29/2024
• 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: Hospitalization; Required Intervention
• Patient Sex: Unknown