inforMED
MalfunctionOSH

UNKNOWN ORTHOPEDIATRICS PEDICLE SCREW

Received Feb 24, 2020

Report 3006460162-2019-00063 · MDR key 9744126

Device

Generic name

Pedicle Screw Spinal System

Model number

N/A

Catalog number

UNKNOWN

Lot number

UNKNOWN

Product problems

  • Fracture
  • Fracture

Patient

16 YR

  • No Known Impact Or Consequence To Patient
  • No Known Impact Or Consequence To Patient

Narrative

Additional Manufacturer Narrative

(B)(4). REPORTER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ORTHOPEDIATRICS FOR INVESTIGATION AS IT REMAINS IMPLANTED.

Description of Event or Problem

IT HAS BEEN REPORTED THAT FOLLOWING THE PLACEMENT OF A SPINAL CONSTRUCT, A SCREW WAS NOTED TO HAVE FRACTURED. NO ADVERSE EVENTS HAVE BEEN REPORTED AS A RESULT OF THE MALFUNCTION.

Additional Manufacturer Narrative

THE FOLLOW IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. UPDATED: H6 UPDATED METHOD 4114 4119. H6 UPDATED RESULTS 3252. H6 UPDATED CONCLUSION 4315. COMPLAINT SAMPLE WAS NOT RETURNED FOR EVALUATION. REPORTED EVENT WAS NOT CONFIRMED. DHR REVIEW WAS UNABLE TO BE PERFORMED AS THE LOT NUMBER OF THE INVOLVED DEVICE IS UNKNOWN. RISK MANAGEMENT FILE REVIEW WAS DEEMED APPROPRIATE. ROOT CAUSE WAS UNABLE TO BE DETERMINED.