inforMED
MalfunctionJDW

LOCKING SCREW AXSOS 4.0MM/L28MM

Received Mar 27, 2012 · Event occurred Mar 8, 2012

Report 8031020-2012-00095 · MDR key 2530715

Device

Generic name

Implant

Model number

NA

Catalog number

371528

Lot number

UNK

Product problems

  • Break
  • Detachment Of Device Component

Patient

96 YR

  • No Information

Narrative

Description of Event or Problem

IT WAS REPORTED, "THE DOCTOR WAS INSERTING A 4.0MM X 28MM AXSOS LOCKING SCREW INTO A PROXIMAL HUMERAL PLATE LOCKING HOLE USING THE POWER SCREWDRIVER WITHOUT A TORQUE LIMITER. WHEN THE SCREW REACHED ITS FINAL POSITION IN THE PLATE, THE HEAD OF THE SCREW BROKE OFF. THE DOCTOR THEN DECIDED TO LEAVE THE REST OF THE SCREW IN."

Additional Manufacturer Narrative

ADDITIONAL INFORMATION HAS BEEN REQUESTED. IF ADDITIONAL INFORMATION IS RECEIVED IT WILL BE PROVIDED ON A SUPPLEMENTAL REPORT.

Remedial action

  • Other