MAUDE Adverse Event Report: SYNTHES GMBH LOW PROF LCKNG SCREW F/IM NAIL Ø 5.0MM / L 66MM / XL25/ STER; SCREW, FIXATION, BONE

Catalog Number	04.045.366TS
Medical Device Problem Codes	Break (1069); Device Slipped (1584)
Health Effect - Clinical Code	Insufficient Information (4580)
Date of Event	01/01/2026
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
Product complaint # (b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803 (and/or part 4, as applicable).This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by depuy synthes, or its employees that the report constitutes an admission that the product, depuy synthes, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Event or Problem Description
It was reported that on (b)(6) 2026 the patient underwent a removal of a loose screw from a tna.When taking out the protruding screw, it was discovered that the second interlock was broken.This was a month to the day after the surgery.This complaint is regarding both proximal interlocks breaking within 28 days of implantation.They were 66 and 64 mm 5.0 low profile ans 5.0 interlocking screws.This report captures the second revision surgery performed on (b)(6) 2026 due two (2) loose/broken proximal interlocking screws while related complaint (b)(4) captures the first removal surgery performed on (b)(6) 2026 due to nonunion/malunion.
Additional Manufacturer Narrative
Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.If the information is unknown, not available or does not apply, the section/field of the form is left blank.H11 additional narrative: added: d10 concomitant, h4.Corrected: g1 manufacturer site.H6 component codes: most relevant component code is g07002 (appropriate term/code not available) to capture no findings available due to no product returned.Investigation summary.Product was not returned.Based on the information available, it has been determined that no corrective and preventative action is proposed.This complaint will be accounted for and monitored via post market surveillance activities.If additional information is made available, the investigation will be updated as applicable device history lot.A manufacturing record evaluation was performed for the finished device.Product code: 04.045.366ts-us.Lot number: 47941p9.It was electronically reviewed and no nonconformances / manufacturing irregularities were identified during the manufacturing process.The product was released on: 06 feb 2025.Manufacturing site: jabil grenchen.Expiry date: 31 jan 2030.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.

• Brand Name: LOW PROF LCKNG SCREW F/IM NAIL Ø 5.0MM / L 66MM / XL25/ STER
• Common Device Name: SCREW, FIXATION, BONE
• Manufacturer (Section D): SYNTHES GMBH; luzernstrasse 19-21; zuchwil 4528 ; SZ 4528
• Manufacturer (Section G): WERK GRENCHEN; solothurnstrasse 186; grenchen CO ; SZ
• Manufacturer Contact: elba bello ; 1302 wrights lane east; west chester, PA 19380 ; 9083863534
• MDR Report Key: 24780215
• Report Number: 8030965-2026-03113
• Device Sequence Number: 13270957
• Product Code: HWC
• UDI-Device Identifier: 10886982301062
• UDI-Public: (01)10886982301062(17)300131(10)47941P9
• Combination Product (Y/N): N
• Initial Reporter State: TX
• Initial Reporter Country: US
• PMA/510(K) Number: K201346
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2026
• Device Explanted Year: 2026
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup

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
• Operator of Device: Health Professional
• Device Catalogue Number: 04.045.366TS
• Device Lot Number: 47941P9
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Follow-Up
• Initial Date Received by Manufacturer: 03/17/2026
• Supplement Date Received by Manufacturer: 04/24/2026
• Initial Report FDA Received Date: 04/03/2026
• Supplement Report FDA Received Date: 04/27/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 02/06/2025
• 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
• Concomitant Medical Products and Therapy/Usage Dates: LOW PROF LCKNG SCR 5.0 / 66 /XL25/ S.
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Sex: Unknown