inforMED
MalfunctionOBT

EPIFIX GROWTH CONTROL SYSTEM

Received Sep 12, 2020 · Event occurred Jun 24, 2020

Report 3013680140-2020-00003 · MDR key 10526090

Device

Generic name

Guided Growth Plate

Model number

PK-EFC0224T

Catalog number

PK-EFC0224T

Lot number

23202

Product problems

  • Fracture
  • Fracture

Patient

13 YR

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

MULTIPLE MDRS REPORTED FOR THE SAME PATIENT EVENT, SEE 3013680140-2020-00001 & 3013680140-2020-00002. DURING INVESTIGATION, ALL MANUFACTURING RECORDS WERE FOUND TO BE CONFORMING. ROOT CAUSE IDENTIFIED TO BE ENGINEERING SPECIFICATION ERROR WHICH ALLOWED MANUFACTURING VARIABILITY AND ULTIMATELY A THIN WALL CONDITION. THIS IS THE COMPANY'S FIRST COMPLAINT; WE HAVE BEEN WORKING WITH THE ESIG AND EMDR TEAMS TO GAIN ACCESS AND HAVE A SUCCESSFUL TEST SUBMISSION OVER THE PAST 2 MONTHS HENCE THE DELAY IN 30-DAY REPORTING.

Description of Event or Problem

IT WAS REPORTED THAT SCREWS PULLED THROUGH 3 OF THE EPIFIX PLATES DURING SURGERY. IT WAS REPORTED THAT THIS DID NOT AFFECT THE OUTCOME OF THE SURGERY ON THE PATIENT. NO INJURY OR DELAY OF SURGERY WAS REPORTED. 3 PLATES WERE EXPLANTED, REMAINING 4 PLATES WERE IMPLANTED SUCCESSFULLY. NO ALLEGATIONS WERE REPORTED AGAINST THE SCREWS OR INSTRUMENTS IN THE PROCEDURAL KITS. THIS IS DEVICE 3 OF 3 (SEE 3013680140-2020-00001 & 3013680140-2020-00002 FOR REMAINING DEVICES). DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS.

Remedial action

  • Modification/Adjustment