FDA Adverse Event Injury Summary report: N

ATTUNE RP TIB BASE SZ 4 CEM

MDR report key: 10237707 · Received July 6, 2020

Report

Report Number
1818910-2020-15088
Event Type
Injury
Date Received
July 6, 2020
Date of Event
March 16, 2020
Report Date
June 24, 2020
Manufacturer
DEPUY IRELAND - 9616671
Product Code
NJL
UDI-DI
10603295042587
PMA / PMN Number
P830055
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT # (B)(4). INVESTIGATION SUMMARY : NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. DEPUY SYNTHES CONSIDERS THE INVESTIGATION CLOSED. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION MAY BE RE-OPENED AS NECESSARY. DEVICE HISTORY LOT : PRODUCT CODE 150610004, WORK ORDER (B)(4) WAS MANUFACTURED ON 08- JUN -2014. (B)(4) PARTS WERE MANUFACTURED PER SPECIFICATION AND ALL RAW MATERIALS MET SPECIFICATION. THERE WAS NO SCRAP ASSOCIATED WITH THIS LOT. THERE WAS ONE REPROCESSING ASSOCIATED WITH THIS LOT, - MRR NO. 1306838 - 20 PART WAS REPROCESSED FOR FIT FOR USE (NC-041585). THERE IS NO CORRELATION WITH THIS REPROCESSING AND THE FAILURE MODE. PATIENT CODE: NO CODE AVAILABLE (3191) IS USED TO CAPTURE BONE DISORDER. DEVICE CODE: REMOVED CODE FOR UNINTENDED MOVEMENT AND REPLACED WITH MIGRATION.

Additional Manufacturer Narrative · 1

(B)(4). INITIAL REPORTER OCCUPATION: LAWYER. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

PATIENT RECEIVED A RIGHT PRIMARY ATTUNE TO TREAT PAIN SECONDARY TO DEGENERATIVE JOINT DISEASE. THE PATELLA WAS RESURFACED AND DEPUY CEMENT X 2 WAS UTILIZED. THE SURGEON NOTES THE SURGERY REQUIRED ADDITIONAL ASSISTANCE DUE TO THE PATIENT¿S SEVERE OBESITY WITH A BMI GREATER THAN 40. THE PROCEDURE WAS COMPLETED WITHOUT COMPLICATIONS. PATIENT RECEIVED A RIGHT KNEE REVISION TO TREAT PAIN AND INSTABILITY SECONDARY TO LOOSENING AND VARUS MIGRATION OF THE TIBIAL TRAY. UPON ENTERING THE JOINT, THE SURGEON IDENTIFIED AND EXCISED SYNOVITIS AND SCAR TISSUE. THE TIBIAL TRAY WAS SUBSIDED AND WAS GROSSLY LOOSE AND DEBONDED AT THE CEMENT TO IMPLANT INTERFACE. THERE WAS A CORTICAL BONE DEFECT OF THE TIBIA. THE FEMORAL COMPONENT WAS WELL-BUT REVISED. THE SURGEON NOTES THERE WAS SLIGHT LOOSENING OF THE FEMORAL COMPONENT SECONDARY TO EXTENSIVE OSTEOLYSIS. THE PATELLA WAS WELL-FIXED AND RETAINED. THERE WAS NO REPORTED PRODUCT PROBLEM WITH THE EXPLANTED TIBIAL INSERT. THE PATIENT WAS REVISED WITH DEPUY REVISION PRODUCTS UTILIZING COMPETITOR CEMENT. THE SURGEON NOTES THE SURGERY REQUIRED ADDITIONAL ASSISTANCE DUE TO THE PATIENT¿S SEVERE OBESITY WITH A BMI GREATER THAN 40. THE PROCEDURE WAS COMPLETED WITHOUT COMPLICATIONS. DOI: (B)(6) 2014. DOR: (B)(6) 2020. LEFT KNEE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
695324 ATTUNE RP TIB BASE SZ 4 CEM ATTUNE IMPLANT : KNEE TIBIAL TRAY NJL DEPUY IRELAND - 9616671 1506-10-004 7920045 10603295042587

Patients

Seq Age Sex Outcome Treatment
1 66 YR Required Intervention ATTUNE MEDIAL ANAT PAT 32MM| ATTUNE PS FEM LT SZ 5 NAR CEM| ATTUNE PS RP INSRT SZ 5 8MM| ATTUNE RP TIB BASE SZ 4 CEM| SMARTSET GMV 40G US EO| SMARTSET MV 40G - EO