MAUDE Adverse Event Report: I.T.S. GMBH CLAVICLE PLATE 3.5MM; CLAVICLE PLATE 3.5MM, 10-HOLE

Model Number	21122-10
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Code	Loss of fracture reduction (4901)
Date of Event	04/03/2026
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
We have inspected the dhf of the affected plate and the material certificate and the batch was processed through the normal manufacturing and inspection operations with no non-conformances or rework noted.The article met all dimensional and visual criteria at the time of release with no issues documented during the manufacture that would contribute to this complaint condition.A definitive root cause could not be established following a technical investigation of the device, a clinical follow-up with the operating surgeon and an independent trauma surgeon regarding the circumstances of the event.According to the operating surgeon, the incident occurred while the compliant patient was asleep, with no known trauma.The independent trauma surgeon confirms proper use and professional reduction.A clear radiological assessment of the bone healing process - particularly regarding delayed fracture healing - was not possible based on the available images.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 information is obtained that was not available for the initial medwatch, a follow up medwatch will be filed as appropriate.This report does not reflect a conclusion by fda, i.T.S.Gmbh or its employees that the report constitutes an admission that the device caused or contributed to the potential event described in this report.
Event or Problem Description
It was reported that a clavicle plate 10-hole broke approx.3,5 months post-op.

• Brand Name: CLAVICLE PLATE 3.5MM
• Common Device Name: CLAVICLE PLATE 3.5MM, 10-HOLE
• Manufacturer (Section D): I.T.S. GMBH; autal 28; lassnitzhoehe, styria 8301 ; AU 8301
• Manufacturer (Section G): I.T.S. GMBH; autal 28; lassnitzhoehe, styria 8301 ; AU 8301
• Manufacturer Contact: florian grill ; autal 28; lassnitzhoehe, styria 8301 ; AU 8301
• MDR Report Key: 25148000
• Report Number: 3004369035-2026-00002
• Device Sequence Number: 10745111
• Product Code: HRS
• UDI-Device Identifier: 09120034305214
• UDI-Public: 09120034305214
• Combination Product (Y/N): N
• Initial Reporter Country: AU
• PMA/510(K) Number: K050852
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2025
• Device Explanted Year: 2026
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Initial Reporter Occupation: Administrator/Supervisor
• Type of Report: Initial
• Report Date (Section B): 05/12/2026

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 Number: 21122-10
• Device Catalogue Number: 21122-10
• Device Lot Number: 679/022332
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 04/23/2026
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 04/15/2026
• Initial Report FDA Received Date: 05/12/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Unknown
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Age: 49 YR
• Patient Sex: Unknown