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As reported: "on tuesday on (b)(6) 2025, i received a message to come in and support a case to remove a broken gamma nail.The surgeon doing the revision case was boopalan ramasamy.The plan was to remove the broken nail, use the synthees ria reamer to try and prevent any infection and then re-fixate the fracture with a smith and nephew nail.Original case date for implantation of the gamma nail was on (b)(6) 2025." 01/27/2026 - upon product return, a broken screw was identified.
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The reported event could be confirmed since the device was returned for evaluation and matches the alleged event.The returned device was visually examined and found to be fractured at the regions corresponding to the lag screw sections.Damage was noted around both the locking screw hole and the oblong hole, which appears consistent with misdrilling.Prominent misdrilling marks were visible on both fracture segments, extending from the posterior to the lateral web.Evidence of deformation was observed on the lateral and posterior sides of the proximal and distal sides, respectively, likely resulting from cyclic loading during functional use.Misdrilling plays a critical role in initiating cracks through the notching effect, thereby compromising the device's structural integrity.The fracture pattern indicates a multifactorial failure mechanism.Fatigue features, such as rest lines, were observed on the posterior web of the proximal fragment, correlating with progressive fatigue failure.In contrast, the anterior web displayed a shiny and smooth fracture surface, indicative of a sudden brittle-type failure.The received locking screw is broken into two fragments as well; the broken surface indicates that the breakage pattern is fatigue in nature, broken due to cyclic load overtime.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.Based on the above investigation, the breakage of nail contributes to multifactorial fatigue and is brittle in nature.No product related issue could be detected during the performed investigation of the returned device.Regarding the root cause of the implant failure no conclusive statement can be provided, because key clinical information (e.G.X-rays in different planes, clinical status, patient activity, assessment of the treating physician or operation reports) is missing.The root causes in such cases are often complex and multifactorial and cannot be determined scientifically without this decisive evidence.Due to these limitations, we are unable in such cases to provide statements about the patient, the procedure and/or the device in relation to cause of the failure.If more information is provided, the case will be reassessed.
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As reported: "on tuesday (b)(6) 2025 i received a message to come in and support a case to remove a broken gamma nail.The surgeon doing the revision case was boopalan ramasamy.The plan was to remove the broken nail, use the synthees ria reamer to try and prevent any infection and then re-fixate the fracture with a smith and nephew nail.Original case date for implantation of the gamma nail was (b)(6) 2025." 01/27/2026 - upon product return, a broken screw was identified.
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