EXP 635 TI DI SETSCREW
Received Feb 22, 2023 · Event occurred Feb 1, 2023
Report 1526439-2023-00324 · MDR key 16419905
Device
Generic name
Pedicle Screw Spinal System, Adolescent Idiopathic Scoliosis
Manufacturer
Medos International Sã rl ChModel number
179922000Catalog number
179922000
Product problems
- Migration
- Migration
Patient
Unknown
- Failure of Implant
- Failure of Implant
Narrative
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. ADDITIONAL NARRATIVE: ADDITIONAL DEVICE PRODUCT CODES: MNI, NKB, KWP, MNH, KWQ. COMPLAINANT PART IS NOT EXPECTED TO BE RETURNED FOR MANUFACTURER REVIEW/INVESTIGATION. WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. PRODUCT WAS NOT RETURNED. BASED ON THE INFORMATION AVAILABLE, IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND/OR 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 WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.
Description of Event or Problem
IT WAS REPORTED THAT ON (B)(6) 2023, THE SURGEON SENT TEXT WITH PICTURE OF PATIENT FILMS SHOWING SLIPPAGE OF THE ROD ON A PEDIATRIC SCOLIOSIS PATIENT. THE DISTAL SCREW OF THE 6.35 WITH COCR RODS AND DI SET SCREWS SLIPPED OFF THE ROD. THIS REPORT IS FOR ONE (1) EXP 635 TI DI SETSCREW. THIS IS REPORT 1 OF 2 FOR COMPLAINT (B)(4).