BEUDAMED
    FDA Adverse Event Injury Summary report: N

    AS ENDURO FEMORAL COMPONENT CEMENTED F1R

    MDR report key: 12407850 · Received September 1, 2021

    Report

    Report Number
    9610612-2021-00529
    Event Type
    Injury
    Date Received
    September 1, 2021
    Report Date
    September 30, 2021
    Manufacturer
    AESCULAP AG
    Product Code
    JWH
    PMA / PMN Number
    K101815
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 0

    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.

    Additional Manufacturer Narrative · 0

    MANUFACTURING SITE EVALUATION: INVESTIGATION ON-GOING. ADDITIONAL INFORMATION / INVESTIGATION RESULTS WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.

    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: NR400Z - AS NUT F/FEMUR EXTENS.STEM ALL SZ.NEUTR. - LOT 52553246; NR440Z - AS FEMUR EXTENS.STEM 5° D20X177 CEM.LESS - LOT 52350154; NR873Z - AS ENDURO MENISCAL COMPONENT F1 16MM - LOT UNKNOWN.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT THERE WAS AN ISSUE WITH AE-QAS-K521-55 - COLLECT.NO.QAS KNEE IMPLANTS ROTAT. 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 WAS NOT PROVIDED. ADDITIONAL INFORMATION HAS BEEN REQUESTED BUT NOT YET RECEIVED AS OF THIS REPORT. ADDITIONAL PATIENT INFORMATION IS NOT AVAILABLE. THE ADVERSE EVENT IS FILED UNDER (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1303761 AS ENDURO FEMORAL COMPONENT CEMENTED F1R KNEE ENDOPROSTHETICS JWH AESCULAP AG NB017Z 52537585

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Required Intervention NR400Z - LOT 52553246| NR440Z - LOT 52350154| NR873Z - LOT UNKNOWN