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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PARAGON 28 SCW DRV ATCH SD AO HX-10 SHT TPR; SCREW, FIXATION, BONE

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PARAGON 28 SCW DRV ATCH SD AO HX-10 SHT TPR; SCREW, FIXATION, BONE Back to Search Results
Catalog Number P99-191-TR10
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/12/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).G2: foreign - event occurred in australia.The device will not be returned for analysis; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental medwatch 3500a will be submitted.
 
Event or Problem Description
It was reported that during fixation of a fibula plate, a screwdriver broke while inserting a screw.The broken portion was removed intra-operatively and the procedure was completed as planned with no consequences or impact to the patient.Delay of surgery was less than 30 minutes.No further information is available.
 
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Brand Name
SCW DRV ATCH SD AO HX-10 SHT TPR
Common Device Name
SCREW, FIXATION, BONE
Manufacturer (Section D)
PARAGON 28
14445 grasslands dr.
englewood CO 80112
Manufacturer (Section G)
PARAGON 28
14445 grasslands dr.
englewood CO 80112
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key24627353
Report Number3008650117-2026-00073
Device Sequence Number9173842
Product Code HWC
UDI-Device Identifier00889795041326
UDI-Public(01)00889795041326(10)TC2304701
Combination Product (Y/N)N
Initial Reporter CountryAS
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Distributor
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 03/18/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Catalogue NumberP99-191-TR10
Device Lot NumberTC2304701
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/13/2026
Initial Report FDA Received Date03/18/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Patient SexUnknown
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