MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2018-05-14 for TI MATRIXNEURO SCREW SELF-DRILLING 4MM 04.503.104.04S manufactured by Oberdorf Synthes Produktions Gmbh.
[108196202]
Patient information not available for reporting. (b)(4). Device malfunctioned intra-operatively and was not implanted/explanted. Complainant part is expected to be returned for manufacturer review/investigation, but has yet to be received. A review of the device history records has been requested. The investigation could not be completed; no conclusion could be drawn, as no product was received. 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
[108196203]
Device report from synthes europe reports an event in (b)(6) as follows: it was reported that during an unknown procedure to implant an unknown plate and four (4) matrixneuro screws on (b)(6)2018, two (2) of the screw heads broke off during insertion. All fragments were removed, no fragments remained in the patient. Surgery was completed with no delay and no adverse consequence to the patient. Concomitant devices reported: plate (part number unknown, lot number unknown, quantity 1), matrixneuro screw self-drilling 4mm (04. 503. 104. 04s, lot number unknown, quantity 2). This report is for one (1) matrixneuro screw 4mm. This is report 1 of 2 for (b)(4).
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 8030965-2018-53753 |
| MDR Report Key | 7512428 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2018-05-14 |
| Date of Report | 2018-04-23 |
| Date of Event | 2018-04-18 |
| Date Mfgr Received | 2018-06-21 |
| Device Manufacturer Date | 2017-12-19 |
| Date Added to Maude | 2018-05-14 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MICHAEL COTE |
| Manufacturer Street | 1302 WRIGHTS LANE EAST |
| Manufacturer City | WEST CHESTER PA 19380 |
| Manufacturer Country | US |
| Manufacturer Postal | 19380 |
| Manufacturer Phone | 6107195000 |
| Manufacturer G1 | SYNTHES SELZACH |
| Manufacturer Street | BOHACKERWEG 5 |
| Manufacturer City | SELZACH 2545 |
| Manufacturer Country | SZ |
| Manufacturer Postal Code | 2545 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TI MATRIXNEURO SCREW SELF-DRILLING 4MM |
| Generic Name | PLATE,CRANIOPLASTY,PREFORMED,ALTERABLE |
| Product Code | GWO |
| Date Received | 2018-05-14 |
| Returned To Mfg | 2018-05-22 |
| Catalog Number | 04.503.104.04S |
| Lot Number | L699917 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | OBERDORF SYNTHES PRODUKTIONS GMBH |
| Manufacturer Address | EIMATTSTRASSE 3 OBERDORF 4436 SZ 4436 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2018-05-14 |