FDA Adverse Event Injury Summary report: N

AS ENDURO FEMORAL COMPONENT CEMENTED F1R

MDR report key: 12396161 · Received August 31, 2021

Report

Report Number
2916714-2021-00174
Event Type
Injury
Date Received
August 31, 2021
Report Date
October 8, 2021
Manufacturer
AESCULAP AG
Product Code
JWH
Adverse Event
Yes
Product Problem
Yes
Report Source
Distributor report
Reporter Location
AZ, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

MANUFACTURING SITE EVALUATION: ADDITIONAL INFORMATION / INVESTIGATION RESULTS WILL BE PROVIDED IN A SUPPLEMENTAL REPORT, IF AVAILABLE.

Additional Manufacturer Narrative · 0

THE COMPONENTS USED WERE THE FOLLOWING: 4X CEMENT BONE FULL DOSE RADIOPAQUE SIMPLEX (STRYKER) NR400Z1 AS NUT F/FEMUR EXTENS.STEM ALL SZ.NEUTR(AESCULAP INC.); IMPLANT SITE: RIGHT KNEE LOT NUMBER: 52553246. NR440Z AS FEMUR EXTENS.STEM 5° D20X177 CEM.LESS (AESCULAP INC.); IMPLANT SITE: RIGHT KNEE LOT NUMBER: 52350154. NR873Z AS ENDURO MENISCAL COMPONENT F1 16MM (AESCULAP INC.); IMPLANT SITE: RIGHT KNEE. INVESTIGATION RESULTS: AS OF THE DATE OF THIS REPORT THE COMPLAINT PRODUCT WAS NOT PROVIDED FOR INVESTIGATION. THEREFORE, A THOROUGH INVESTIGATION IS NOT POSSIBLE. BATCH HISTORY REVIEW: THE DEVICE QUALITY AND MANUFACTURING HISTORY RECORDS HAVE BEEN CHECKED FOR THE AVAILABLE LOT NUMBER AND WERE FOUND TO BE ACCORDING TO OUR SPECIFICATIONS VALID AT THE TIME OF PRODUCTION. REVIEW OF THE COMPLAINT HISTORY REVEALED THAT NO SIMILAR COMPLAINTS HAVE BEEN FILED AGAINST PRODUCTS FROM THIS BATCH NUMBER. CONCLUSION AND MEASURES / PREVENTIVE MEASURES: BASED UPON THE INVESTIGATION RESULTS A CLEAR ROOT CAUSE CONCLUSION CANNOT BE DRAWN. THERE IS NO INDICATION FOR A MATERIAL-, MANUFACTURING- OR DESIGN-RELATED FAILURE. IN THE EVENT THAT THE COMPLAINT PRODUCT WILL BE PROVIDED FOR INVESTIGATION IN THE FUTURE, AN UPDATE OF THIS REPORT WILL BE PROVIDED UNSOLICITED. BASED UPON THE INVESTIGATIONS RESULTS A CAPA IS NOT NECESSARY.

Description of Event or Problem · 0

ADDITIONAL INFORMATION RECEIVED ON 03.SEP. 2021. MULTIPLE UNSPECIFIED KNEE SURGERIES WERE PERFORMED PRIOR TO THIS. INITIAL SURGERY DATE : (B)(6) 2020. INVOLVED COMPONENTS: THE COMPONENTS USED WERE THE FOLLOWING: 4X CEMENT BONE FULL DOSE RADIOPAQUE SIMPLEX (STRYKER). NR400Z1 AS NUT F/FEMUR EXTENS.STEM ALL SZ.NEUTR(AESCULAP INC.); IMPLANT SITE: RIGHT KNEE LOT NUMBER: 52553246. NR440Z AS FEMUR EXTENS.STEM 5° D20X177 CEM.LESS (AESCULAP INC.); IMPLANT SITE: RIGHT KNEE LOT NUMBER: 52350154. NR873Z AS ENDURO MENISCAL COMPONENT F1 16MM (AESCULAP INC.); IMPLANT SITE: RIGHT KNEE.

Description of Event or Problem · 0

NO UPDATES.

Additional Manufacturer Narrative · 1

MANUFACTURING SITE EVALUATION: ADDITIONAL INFORMATION / INVESTIGATION RESULTS WILL BE PROVIDED IN A SUPPLEMENTAL REPORT, IF AVAILABLE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THERE WAS AN ISSUE WITH AE-QAS-K521-55 - COLLECT.NO.QAS KNEE IMPLANTS ROTATE HINGE. ACCORDING TO THE COMPLAINT DESCRIPTION, THE PATIENT NEEDS THEIR CURRENT AESCULAP ENDURO AS KNEE REVISION FEMORAL COMPONENT CONVERTED TO A CUSTOMIZED FEMORAL COMPONENT THAT CAN FIX INTO THE REMAINING HEALTHY BONE. A REVISION SURGERY WAS NECESSARY. ADDITIONAL INFORMATION HAS BEEN REQUESTED BUT NOT YET RECEIVED AS OF THIS REPORT. THE ADVERSE EVENT IS FILED UNDER AAG REFERENCE (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1299997 AS ENDURO FEMORAL COMPONENT CEMENTED F1R KNEE ENDOPROSTHETICS JWH AESCULAP AG NB017Z 52537585

Patients

Seq Age Sex Outcome Treatment
1 52 YR Required Intervention