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 2018-05-15 for TI MATRIXNEURO SCREW SELF-DRILLING 5MM 04.503.105.01S manufactured by Oberdorf Synthes Produktions Gmbh.
[108274236]
Additional narrative: patient information is unknown. Additional procode: gxr. Device has not been explanted. Complainant part is expected to be returned for manufacturer review/investigation, but has yet to be received. The investigation could not be completed; no conclusion could be drawn, as no product was received. A device history records review has been requested. 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
[108274237]
Device report from synthes europe reports an event in (b)(6) as follows: it was reported that the surgeon requested for the matrix system to reinsert the bone back to head. While the surgeon was screwing the bone and the plate the head of the screw come off from the tail. The surgeon tried another 4 screws and all the heads came off from the tails. They removed the system from the sterile field and used a different kit to continue the operation. The surgeon did try to remove the broken screws but he abandoned the attempt as he would have damaged the bone flap. There was no harm to the patient as the screws were being screwed into the hole on the plate on the scrub nurses trolley not in the patient? S head. Patient status is unknown. Concomitant devices: unknown matrixneuro plate (part/lot number: unknown, quantity 1). This report is for a ti matrixneuro screw self-drilling 5mm. (b)(4).
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 8030965-2018-53766 |
| MDR Report Key | 7514677 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2018-05-15 |
| Date of Report | 2018-04-25 |
| Date of Event | 2018-04-20 |
| Date Mfgr Received | 2018-07-23 |
| Device Manufacturer Date | 2018-02-27 |
| Date Added to Maude | 2018-05-15 |
| 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 | WERK BETTLACH (CH) |
| Manufacturer Street | MURACHERSTRASSE 3 |
| Manufacturer City | BETTLACH CO 2544 |
| Manufacturer Country | SZ |
| Manufacturer Postal Code | 2544 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TI MATRIXNEURO SCREW SELF-DRILLING 5MM |
| Generic Name | PLATE, CRANIOPLASTY, PREFORMED, ALTERABLE |
| Product Code | GWO |
| Date Received | 2018-05-15 |
| Returned To Mfg | 2018-06-11 |
| Catalog Number | 04.503.105.01S |
| Lot Number | L789487 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | * |
| 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 | 2018-05-15 |