FDA Adverse Event Injury Summary report: N

MAKO X3 UNI ONLAY TIBIAL INSERT SIZE 5 - 10 MM

MDR report key: 10395852 · Received August 12, 2020

Report

Report Number
0002249697-2020-01649
Event Type
Injury
Date Received
August 12, 2020
Date of Event
July 24, 2020
Report Date
August 12, 2020
Manufacturer
STRYKER ORTHOPAEDICS-MAHWAH
Product Code
NPJ
UDI-DI
00848486016562
PMA / PMN Number
K150307
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
RI, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

REVIEW OF THE DEVICE HISTORY RECORDS INDICATE THAT DEVICES WERE MANUFACTURED AND ACCEPTED INTO FINAL STOCK WITH NO REPORTED DISCREPANCIES. THERE HAVE BEEN NO OTHER EVENTS FOR THE LOT REFERENCED. IF ADDITIONAL INFORMATION IS RECEIVED, IT WILL BE PROVIDED IN A SUPPLEMENTAL REPORT UPON COMPLETION OF THE INVESTIGATION. THE FOLLOWING DEVICES WERE ALSO LISTED IN THIS REPORT: MCK FEMORAL-RM-LL-SZ 4; 180514; 1W6Y-1. MCK TIBIAL BASEPLATE-RM/LL-SZ 5; 180615; 26320719-01. IT CANNOT BE DETERMINED WHICH, IF ANY OF THESE DEVICES MAY HAVE CAUSED OR CONTRIBUTED TO THE PATIENT'S EXPERIENCE. DEVICE NOT RETURNED.

Description of Event or Problem · 1

DR. PERFORMED AN I&D AND INSERT SWAP ON THE RIGHT MEDIAL MAKO UNI DUE TO INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
859480 MAKO X3 UNI ONLAY TIBIAL INSERT SIZE 5 - 10 MM PROSTHESIS, KNEE PATELLOFEMOROTIBIAL, PARTIAL, SEMI-CONSTRAINED, CEMENTED, POLYM NPJ STRYKER ORTHOPAEDICS-MAHWAH 180735-3 XL62NY 00848486016562

Patients

Seq Age Sex Outcome Treatment
1 53 YR Hospitalization| R