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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARTHREX, INC. 5.5X20MM PERIPHERAL SCREW, LOCKING; SHOULDR PROSTH, REVERSE CONFIG

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ARTHREX, INC. 5.5X20MM PERIPHERAL SCREW, LOCKING; SHOULDR PROSTH, REVERSE CONFIG Back to Search Results
Model Number 5.5X20MM PERIPHERAL SCREW, LOCKING
Medical Device Problem Code Patient Device Interaction Problem (4001)
Health Effect - Clinical Code Unspecified Infection (1930)
Date of Event 03/27/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Investigation is in process.A follow-up report will be provided upon availability of additional information.
 
Event or Problem Description
It was reported that after an inverse shoulder prosthesis surgery on (b)(6) 2026 the patient has developed an infection.On (b)(6) 2026 all implants were removed and the affected areas were cleansed and treated.A new prosthesis will be implanted in 6-8 weeks.
 
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Brand Name
5.5X20MM PERIPHERAL SCREW, LOCKING
Common Device Name
SHOULDR PROSTH, REVERSE CONFIG
Manufacturer (Section D)
ARTHREX, INC.
1370 creekside boulevard
naples FL 34108 1945
Manufacturer (Section G)
ARTHREX, INC.
1370 creekside boulevard
naples FL 34108 1945
Manufacturer Contact
jared engle
8009337001
MDR Report Key24903218
Report Number1220246-2026-02242
Device Sequence Number9085463
Product Code PHX
UDI-Device Identifier00888867296824
UDI-Public(01)00888867296824(11)250206(17)300131(10)15385061
Combination Product (Y/N)N
Initial Reporter CountryAU
PMA/510(K) Number
K173900
Number of Events Summarized1
Summary Report (Y/N)N
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Administrator/Supervisor
Type of Report Initial
Report Date (Section B) 04/16/2026
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? No
Operator of Device Health Professional
Device Model Number5.5X20MM PERIPHERAL SCREW, LOCKING
Device Catalogue NumberAR-9563-20
Device Lot Number15385061
Was Device Available for Evaluation? No
Distributor Facility Aware Date03/27/2026
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/27/2026
Initial Report FDA Received Date04/16/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/06/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Other;
Patient SexUnknown
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