FDA Adverse Event Injury Summary report: N

UNKNOWN DEPUY PATELLA

MDR report key: 1233628 · Received November 14, 2008

Report

Report Number
1818910-2008-05203
Event Type
Injury
Date Received
November 14, 2008
Date of Event
October 20, 2008
Report Date
October 20, 2008
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
HTG
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

EXAMINATION WAS NOT POSSIBLE, AS THE DEVICES WERE NOT RETURNED. REVIEW OF THE DEVICE HISTORY RECORDS WAS ALSO NOT POSSIBLE AS THE PRODUCT AND/OR LOT CODES WERE UNAVAILABLE. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY EVIDENCE OF PRODUCT CONTRIBUTION/ERROR WITH REGARD TO THE REPORTED EVENT WITH THE INFO AVAILABLE. BASED ON THE INVESTIGATION, THE NEED FOR CORRECTIVE ACTION IS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADD'L INFO BE REC'D, THE INVESTIGATION WILL BE RE-OPENED.

Description of Event or Problem · 1

PT REVISED TO ADDRESS POLYETHYLENE WEAR OF PATELLA AND INSERT; LOOSENING OF TIBIAL TRAY; FOUND IMPLANT MALPOSITIONED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN DEPUY PATELLA TOTAL KNEE REPLACEMENT HTG DEPUY ORTHOPAEDICS, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 83 YR Required Intervention