inforMED
MalfunctionNKB

ERISMA-LP MIS

Received Mar 4, 2020 · Event occurred Apr 23, 2019

Report 3009962553-2019-00004 · MDR key 9786270

Device

Generic name

6.5mm X 40mm Cannulated Polyaxial Screw

Manufacturer

Clariance Sas

Model number

13016540

Catalog number

13016540

Lot number

GA17C

Product problems

  • Positioning Failure
  • Positioning Failure

Patient

82 YR

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

Narrative

Additional Manufacturer Narrative

THE SCREW WAS RETURNED TO THE MANUFACTURER, HOWEVER, THE SET SCREW WAS NOT RETURNED. AS A CONSEQUENCE, NO ANALYSIS WAS ABLE TO BE PERFORMED. 12/20/2019 - THE SCREW WAS RETURNED TO THE MANUFACTURER, HOWEVER, THE SET SCREW WAS NOT RETURNED. AS A CONSEQUENCE, NO ANALYSIS WAS ABLE TO BE PERFORMED.

Description of Event or Problem

THE SET SCREW WOULD NOT START AND ENGAGE THE THREAD OF THE HEAD OF THE ERISMA-LP MIS POLYAXIAL SCREW. THERE WAS A DELAY OF 30 MINUTES ASSOCIATED WITH REMOVING THE SCREW AND REPLACING IT WITH AN ALTERNATIVE PEDICLE SCREW. HOWEVER, NO PATIENT HARM WAS REPORTED AND THE SURGERY COMPLETED WITHOUT FURTHER INCIDENT.

Additional Manufacturer Narrative

THE SCREW WAS RETURNED TO THE MANUFACTURER, HOWEVER, THE SET SCREW WAS NOT RETURNED. AS A CONSEQUENCE, NO ANALYSIS WAS ABLE TO BE PERFORMED.

Description of Event or Problem

THE SET SCREW WOULD NOT START AND ENGAGE THE THREAD OF THE HEAD OF THE ERISMA-LP MIS POLYAXIAL SCREW. THERE WAS A DELAY OF 30 MINUTES ASSOCIATED WITH REMOVING THE SCREW AND REPLACING IT WITH AN ALTERNATIVE PEDICLE SCREW. HOWEVER, NO PATIENT HARM WAS REPORTED AND THE SURGERY COMPLETED WITHOUT FURTHER INCIDENT.

Remedial action

  • Replace