FDA Adverse Event Injury Summary report: N

OPTIMIZED POSITIONING SYSTEM

MDR report key: 11722168 · Received April 25, 2021

Report

Report Number
3012916784-2021-00087
Event Type
Injury
Date Received
April 25, 2021
Date of Event
August 4, 2020
Report Date
April 6, 2021
Manufacturer
OPTIMIZED ORTHO PTY LTD
Product Code
LZO
PMA / PMN Number
K193545
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

NO COMPLAINT DEVICES WERE RETURNED TO OPTIMIZED ORTHO BY THE CUSTOMER. THUS, THE DEVICE PROCESSING FILES WERE INVESTIGATED WHICH INCLUDED REVIEWING OPS PLAN AND DHA. NO OPTIMIZED ORTHO DEVICES WERE INTERFACING WITH THE PATIENT DURING THE SURGERY. THIS FAILURE MODE IS NOT ASSOCIATED WITH THE USE OF OPS PLAN AND DHA IN THE PRIMARY SURGERY. THERE IS NO EVIDENCE TO SUGGEST THAT THE USE OF OPS TECHNOLOGY IN THE PRIMARY SURGERY CONTRIBUTED TO THIS REVISION EVENT. THEREFORE THE CASE IS NOW CONSIDERED CLOSED. THIS REPORT IS FILED WITH THE FDA DUE TO AN EVENT EXPERIENCED WITH A DEVICE THAT IS SAME/SIMILAR TO THOSE PLACED ON THE MARKET IN THE USA, HOWEVER, THIS EVENT OCCURRED OUTSIDE OF THE USA. PLEASE NOTE: THE SUBMISSION OF THIS REPORT DOES NOT CONSTITUTE AND ADMISSION THAT THE DEVICE, REPORTING ENTITY, ENTITY'S REPRESENTATIVE OR DISTRIBUTOR CAUSED OR CONTRIBUTED TO THIS EVENT.

Description of Event or Problem · 0

IT WAS REPORTED BY A CORIN REPRESENTATIVE THAT THE PATIENT WAS REVISED DUE TO INFECTION. OPS PLAN WITH DHA AND FEMORAL GUIDE WERE USED AS AN ASSISTIVE TECHNOLOGY IN THE PRIMARY SURGERY.

Additional Manufacturer Narrative · 1

WE ARE CURRENTLY IN THE PROCESS OF RETRIEVING FURTHER INFORMATION TO PERFORM INVESTIGATION. WE WILL PROVIDE A FOLLOW UP REPORT UPON COMPLETION. THIS REPORT IS FILED WITH THE FDA DUE TO AN EVENT EXPERIENCED WITH A DEVICE THAT IS SAME/SIMILAR TO THOSE PLACED ON THE MARKET IN THE USA, HOWEVER, THIS EVENT OCCURRED OUTSIDE OF THE USA.

Description of Event or Problem · 1

IT WAS REPORTED BY A CORIN REPRESENTATIVE THAT THE PATIENT WAS REVISED DUE TO INFECTION. OPS PLAN WITH DHA AND FEMORAL GUIDE WERE USED AS AN ASSISTIVE TECHNOLOGY IN THE PRIMARY SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
618232 OPTIMIZED POSITIONING SYSTEM OPTIMIZED POSITIONING SYSTEM LZO OPTIMIZED ORTHO PTY LTD OPS PLAN WITH DHA MCL_MZ_17116

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention OPS FEMORAL GUIDE| OPS FEMORAL GUIDE| OPS FEMORAL GUIDE