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It was reported that after an initial bunion surgery on (b)(6) 2025, two screws were removed on (b)(6) 2025 due to a screw that backed out.During the original surgery, the capital fragment (cf) plantarly translated when cf screws were inserted.When manually backing the screw out only slightly, the cf returned to proper anatomical alignment.As a result, the surgeon chose to keep the hardware and correction as-is.It was later discovered that the dorsal 10mm screw backed out.The 10mm screw and an 18mm screw were removed from the patient.One plate, an angled screw, and a bicortical screw remain implanted as the surgeon determined the remaining screws were well-seated and the plate was fused to the bone.Additional information indicates the patient had poor bone quality.No other patient outcomes were reported as a result of this event.No devices were returned for evaluation.The device history records were reviewed and no issues were identified during the manufacture and release of the devices that could have contributed to what was reported.A number of factors could have contributed to what was reported and although the most likely cause cannot be determined based on the available information, it is possible the initial placement of the hardware, the patient's poor bone quality and/or post-operative activity of the patient led to loosening of the hardware.The company will supplement this mdr as necessary and appropriate.
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