inforMED
MalfunctionHXX

ERISMA LP

Received Oct 4, 2019 · Event occurred Jul 17, 2017

Report 3009962553-2019-00003 · MDR key 9157930

Device

Generic name

Tube

Manufacturer

Clariance Sas

Model number

18912026

Catalog number

18912026

Lot number

G903N

Product problems

  • Material Fragmentation
  • Material Fragmentation

Patient

Not reported

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

THE BREAKAGE OF THE QUICK-CONNECT ROD WAS CAUSED BY AN INCORRECT ASSEMBLY OF THE SCREWDRIVER BEFORE USE. WHEN THE SCREWDRIVER SHAFT IS NOT PROPERLY ENGAGED IN THE QUICK-CONNECT ROD, THIS CAUSES THE BREAKAGE OF THE STRIPS BY INTERFERING WITH THE WINDOW OF THE SCREWDRIVER TUBE.

Description of Event or Problem

THE SURGEON INITIALLY IMPLANTED A 7.5MM DIAMETER POLYAXIAL SCREW AND WAS UNABLE TO RELEASE THE LOCKING MECHANISM OF THE SCREWDRIVER. AS A CONSEQUENCE, THE SURGEON REMOVED THE POLYAXIAL SCREW INITIALLY IMPLANTED. HE USED ANOTHER SCREWDRIVER READILY AVAILABLE IN THE SET AND REPLACED THE 7.5MM DIAMETER POLYAXIAL SCREW WITH A 8.5MM DIAMETER POLYAXIAL SCREW. NO PATIENT HARM WAS REPORTED AND THE SURGERY WAS COMPLETED WITH NO FURTHER COMPLICATIONS.

Remedial action

  • Replace