SLOTTED SCREW F/CONDYLAR HEAD ADD-ON SYS F/MATRIXMANDIBLE 04.497.001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,07 report with the FDA on 2014-04-11 for SLOTTED SCREW F/CONDYLAR HEAD ADD-ON SYS F/MATRIXMANDIBLE 04.497.001 manufactured by Synthes Usa.

Event Text Entries

[4309582] It was reported that the following event occurred during a secondary mandible resection procedure on (b)(6) 2014. This was a revision of the initial mandible resection surgery, due to a recurrence of cancer. Initial resection surgery was performed on an unknown date. The initial patient specific plate contouring matrix mandible plate and condylar head add-on system were removed. During the revision surgery, the surgeon had difficulty engaging the screws of the condylar add-on plate to the patient specific plate contouring custom implant. Three of the screws stripped, and could not be used. The surgeon had to stop, reassess the bend of the plate and then bend and file the plate a little more in order to decrease the interface between the plate and the custom implant so that the screws would engage the implant. Another set was opened for additional screws. The procedure was prolonged by 25 minutes to manipulate the plate and secure additional screws to complete the procedure. Patient was stable following the revision surgery. This report is 2 of 4 for (b)(4).
Patient Sequence No: 1, Text Type: D, B5


[11832642] Device was used for treatment, not for diagnosis. Implant date: unknown. Without a lot number the device history records review could not be completed. The investigation could not be completed; no conclusion could be drawn, as no product was received. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[11929972] Device was used a treatment, not diagnosis manufacturer: reported as (b)(4) on the initial medwatch without a lot number provided. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate. (b)(4)
Patient Sequence No: 1, Text Type: N, H10


[12273241] Additional narrative: 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.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1000562954-2014-10039
MDR Report Key3741146
Report Source05,07
Date Received2014-04-11
Date of Report2014-03-24
Date of Event2014-03-24
Date Mfgr Received2014-07-09
Date Added to Maude2014-06-05
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactLINDA PLEWS
Manufacturer Street1302 WRIGHTS LANE EAST
Manufacturer CityWEST CHESTER PA 19380
Manufacturer CountryUS
Manufacturer Postal19380
Manufacturer Phone6107195000
Manufacturer G1SYNTHES MEZZOVICO
Manufacturer StreetZONA INDUSTRIALE 4
Manufacturer CityMEZZOVICO CH6805
Manufacturer CountryUS
Manufacturer Postal CodeCH6805
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSLOTTED SCREW F/CONDYLAR HEAD ADD-ON SYS F/MATRIXMANDIBLE
Generic NamePROSTHESIS,CONDYLE,MANDIBULAR TEMPORARY
Product CodeNEI
Date Received2014-04-11
Catalog Number04.497.001
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSYNTHES USA
Manufacturer Address1302 WRIGHTS LANE EAST WEST CHESTER PA 19380CH6 US 19380 CH68


Patients

Patient NumberTreatmentOutcomeDate
10 2014-04-11

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