MAUDE MDR 7236983

MDR report key
7236983
Report number
2939274-2018-50473
Event key
0
Event type
3
Date of event
2018-01-08
Date received
2018-02-02
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MICHAEL COTE
Address
1302 WRIGHT LANE EAST WEST CHESTER PA 19380 US
Phone
610-610-6107
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1HOLLOW GOUGE FOR BROKEN SCREW EXPOSUREGOUGE,SURGICAL,GEN & PLASTIC SURGERYWRIGHTS LANE: SYNTHES USA PRODUCTS LLCGDH399.68* N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12018-02-0201. R

Event Narratives#

N

Patient 1

DEVICE IS AN INSTRUMENT AND IS NOT IMPLANTED/EXPLANTED. DEVICE IS NOT EXPECTED TO BE RETURNED FOR MANUFACTURER REVIEW/INVESTIGATION. DEVICE EVALUATION/INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN AS PRODUCT WAS NOT RETURNED TO MANUFACTURER. DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED WITHOUT LOT NUMBER. 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.

D

Patient 1

IT WAS REPORTED THAT ON (B)(6) 2018, PATIENT UNDERWENT A HARDWARE REMOVAL/REVISION PROCEDURE FOR TOTAL KNEE ARTHROPLASTY (RETROGRADE NAIL WITH 4 INTERLOCKING SCREWS AND ENDCAP). UPON LOCATING THE HARDWARE, IT WAS DISCOVERED THAT ALL OF THE SCREW HEAD RECESS WERE STRIPPED AND SCREWDRIVERS WERE UNSUCCESSFUL FOR REMOVAL. OSTEOTOMES, CURETTES, AND GOUGES WERE USED TO LOOSEN BONE GROWTH AROUND HARDWARE AND A LOCKING PLIER AND VICE GRIP WERE USED TO REMOVE THREE (3) OF THE SCREWS. DURING THIS PROCESS, A SYNTHES GOUGE BROKE AND PORTION OF THE DEVICE MAY HAVE BEEN RETAINED IN THE PATIENT. INTRA-OPERATIVE RADIOGRAPHY WAS UNABLE TO DETERMINE LOCATION OF THE PIECE. SECONDARILY, THE MOST DISTAL SCREW WAS UNABLE TO BE REMOVED AND THE SURGEON DECIDE TO ABORT THE PLANED PROCEDURE. THE REMAINDER OF THE HARDWARE WHICH INCLUDES THE RETROGRADE NAIL AND MOST DISTAL INTERLOCKING SCREW WERE REMOVED WITHOUT INCIDENT DURING ANOTHER PROCEDURE AND ANOTHER FACILITY. THIS COMPLAINT CAPTURES INTRA-OPERATIVE BREAKAGE OF GAUGE. PC- 000110817 CAPTURES THE REMOVAL OF HARDWARE (THREE SCREWS). CONCOMITANT DEVICES REPORTED: RETROGRADE NAIL (PART#: UNKNOWN, LOT #: UNKNOWN, QTY: 1) INTERLOCKING SCREWS (PART #: UNKNOWN, LOT #: UNKNOWN, QTY: 4) ENDCAP (PART #: UNKNOWN, LOT #: UNKNOWN, QTY: UNKNOWN) OSTEOTOMES (PART #: UNKNOWN, LOT #: UNKNOWN, QTY: UNKNOWN) CURETTES (PART #: UNKNOWN, LOT #: UNKNOWN, QTY: UNKNOWN) THIS REPORT IS FOR ONE (1) HOLLOW GOUGE FOR BROKEN SCREW EXPOSURE. THIS IS REPORT 1 OF 1 FOR (B)(4).