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Please note the corrections to d9 and h6 device codes.The reported event could be confirmed based on details provided, only.Images available revealed both distal locking screws to be broken.Due to missing device, a physical evaluation was impossible.Furthermore, images provided were forwarded to an hcp for review and statement his comments ¿ excerpts: both distal screws are broken indeed.The healing status 8 months after surgery is most probably a non-union, there is little/some callus formation, but the fracture lines are still obvious, which is not what you would expect 8 months after surgery.Axial overload had led to continuous stresses and a significant weakening of the nail in the area of the lag screw thru hole, followed by the fatigue fracture after an implantation duration of approx.8 months, which is also supported by both failed locking screws.The screw is not designed to take over the intended use of nail in case of a non-intact situation occurs.The affected nail is designed to withstand the normal loads during the implantation period, i.E., the implant must neither be exposed to peak loads nor to continuous stresses.Another prerequisite for a successful supply is undisturbed, normal bone healing.In case such a situation does not occur, exceeding of the fatigue strength is to be expected and thus quite predictable complications.Due to the broken nail, there was increased force transmission to the locking screw, which then finally broke as a result of overload.Based on the above the screw breakage is rather related to patient conditions and has to be classified as patient-patient factors issue.No discrepancies verified for the nail based on the available details.Adverse effects are clearly listed in the ifu and as pointed out ¿revision and additional surgery may be a consequence of these complications.With information available no deficiency of the screw in question could be verified.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.In case substantive information will become available in future that suggests otherwise we reserve the right to reopen the case.
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