S4 SET SCREW NEW VERSION SW790T

MAUDE Adverse Event Report

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 2020-02-12 for S4 SET SCREW NEW VERSION SW790T manufactured by Aesculap Ag.

Event Text Entries

[179416244] If additional information becomes available a follow up report will be submitted.
Patient Sequence No: 1, Text Type: N, H10


[179416245] It was reported that there was an issue with s4 set screw. According to the customer complaint. "l4/l5 fixation using s4 and sri(spondylolisthesis reduction instrument). When inserting set screws into the screws in l5, the rod was slightly elevated in l4 screws and there was a slight gap between the rod and the screws. In right l4, the surgeon attempted to screw in the set screw using a set screw starter, but the set screw rotated idly, so he removed the set screw in question to replace it with a brand new one. The surgeon used two set screws in the left screw of l4, but both rotated idly in the left side, too. Finally, for the right l4 screw, the surgeon managed to fix the second set screw, and it was successful. For the left, the surgeon attempted carefully to fix one of the two failed set screws, and he succeeded in finally tightening the set screw. There was no need for replacement of pedicle screws. It is unknown exactly how long the surgical procedure was delayed. There was no patient harm. Additional information was not provided nor available / was not available. Additional patient information is not available. The adverse event is filed under (b)(4). Associated medwatch-reports: 9610612-2019-00949 ((b)(4) sw790t).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9610612-2019-00950
MDR Report Key9702351
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-02-12
Date of Report2020-03-31
Date of Event2020-01-17
Date Mfgr Received2020-03-20
Device Manufacturer Date2018-09-13
Date Added to Maude2020-02-12
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS KERSTIN ROTHWEILER
Manufacturer StreetPO BOX 40
Manufacturer CityTUTTLINGEN, 78501
Manufacturer CountryGM
Manufacturer Postal78501
Manufacturer G1AESCULAP AG
Manufacturer StreetPO BOX 40
Manufacturer CityTUTTLINGEN, 78501
Manufacturer CountryGM
Manufacturer Postal Code78501
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameS4 SET SCREW NEW VERSION
Generic NameSPINE SURGERY
Product CodeMNI
Date Received2020-02-12
Returned To Mfg2020-03-16
Model NumberSW790T
Catalog NumberSW790T
Lot Number52457096
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerAESCULAP AG
Manufacturer AddressPO BOX 40 TUTTLINGEN, 78501 GM 78501


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-02-12

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