FDA Adverse Event Injury Summary report: N

ELEOS

MDR report key: 12751635 · Received November 4, 2021

Report

Report Number
3013450937-2021-00250
Event Type
Injury
Date Received
November 4, 2021
Date of Event
October 7, 2021
Report Date
January 3, 2022
Manufacturer
ONKOS SURGICAL
Product Code
KRO
UDI-DI
B27825002111E0
PMA / PMN Number
K161520
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUBMITTED TO INCLUDE ADDITIONAL INFORMATION. THE INVESTIGATION IS COMPLETE. THE DEVICE WAS NOT RETURNED FOR EVALUATION. THE ROOT CAUSE OF THE ALLEGED INFECTION COULD NOT BE DETERMINED. THE DEVICE HISTORY RECORDS AND STERILIZATION BATCH RECORDS WERE REVIEWED AND NO ISSUES DURING MANUFACTURING OR STERILIZATION WERE IDENTIFIED THAT WOULD HAVE CONTRIBUTED TO THIS COMPLAINT. IF ANY ADDITIONAL INFORMATION IS OBTAINED, A SUPPLEMENTAL MDR WILL BE FILED ACCORDINGLY. THE FOLLOWING SECTIONS WERE UPDATED: H3: DEVICE EVALUATED BY MANUFACTURER UPDATED TO NO. H6: TYPE OF INVESTIGATION CODE UPDATED TO 3331: ANALYSIS OF PRODUCTION RECORDS. H6: TYPE OF INVESTIGATION CODE UPDATED TO 4111: COMMUNICATION/INTERVIEWS. H6: TYPE OF INVESTIGATION CODE UPDATED TO 4110: TREND ANALYSIS. H6: TYPE OF INVESTIGATION CODE UPDATED TO 4114: DEVICE NOT RETURNED. H6: TYPE OF INVESTIGATION CODE UPDATED TO 4117: DEVICE NOT ACCESSIBLE FOR TESTING. H6: TYPE OF INVESTIGATION CODE UPDATED TO 4109: HISTORICAL DATA ANALYSIS. H6: INVESTIGATION FINDINGS CODE UPDATED TO 213: NO DEVICE PROBLEM FOUND. H6: INVESTIGATION CONCLUSIONS CODE UPDATED TO 4315: CAUSE NOT ESTABLISHED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT DEVELOPED AN ALLEGED INFECTION AND UNDERWENT A REVISION SURGERY ON (B)(6) 2021. THE FOLLOWING ELEOS IMPLANTS WERE REVISED: MALE-FEMALE MIDSECTION (40MM). DISTAL FEMUR, TIBIAL HINGE COMPONENT, DISTAL FEMUR AXIAL PIN, AND POLY SPACER. THE FOLLOWING ELEOS IMPLANTS REMAIN IMPLANTED FROM THE ORIGINAL SURGERY: CANAL-FILLING SEGMENTAL STEM (11X152MM), TIBIAL BASEPLATE, AND CANAL-FILLING STEM EXTENSION (12X100MM). NO ADDITIONAL INFORMATION REGARDING THIS ADVERSE EVENT HAS BEEN PROVIDED.

Additional Manufacturer Narrative · 1

THE INVESTIGATION IS STILL IN PROCESS. WHEN THE INVESTIGATION IS COMPLETE, A SUPPLEMENTAL MDR WILL BE SUBMITTED ACCORDINGLY. MULTIPLE MDRS WERE SUBMITTED FOR THIS EVENT: #3013450937-2021-00246, #3013450937-2021-00247, #3013450937-2021-00248, #3013450937-2021-00249, #3013450937-2021-00251, #3013450937-2021-00252, #3013450937-2021-00253.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT DEVELOPED AN ALLEGED INFECTION AND UNDERWENT A REVISION SURGERY ON (B)(6) 2021. THE FOLLOWING ELEOS IMPLANTS WERE REVISED: MALE-FEMALE MIDSECTION (40MM). DISTAL FEMUR, TIBIAL HINGE COMPONENT, DISTAL FEMUR AXIAL PIN, AND POLY SPACER. THE FOLLOWING ELEOS IMPLANTS REMAIN IMPLANTED FROM THE ORIGINAL SURGERY: CANAL-FILLING SEGMENTAL STEM (11X152MM), TIBIAL BASEPLATE, AND CANAL-FILLING STEM EXTENSION (12X100MM). NO ADDITIONAL INFORMATION REGARDING THIS ADVERSE EVENT HAS BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1650882 ELEOS DISTAL FEMUR AXIAL PIN, ONE SIZE KRO ONKOS SURGICAL 25002111E 1857435 B27825002111E0

Patients

Seq Age Sex Outcome Treatment
1 68 YR Female Hospitalization| R P/N 25000009E, ELEOS DISTAL FEMUR| P/N 25001040E, ELEOS MALE-FEMALE MIDSECTION| P/N 25001208E, ELEOS TIBIAL POLY SPACER| P/N 25002101E, ELEOS TIBIAL HINGE COMPONENT| P/N 25002202E, ELEOS TIBIAL BASEPLATE| P/N FB-11152-03M, ELEOS CANAL-FILLING STEM| P/N KSP11100E, ELEOS STEM EXTENSION| P/N 25000009E, ELEOS DISTAL FEMUR| P/N 25001040E, ELEOS MALE-FEMALE MIDSECTION| P/N 25001208E, ELEOS TIBIAL POLY SPACER| P/N 25002101E, ELEOS TIBIAL HINGE COMPONENT| P/N 25002202E, ELEOS TIBIAL BASEPLATE| P/N FB-11152-03M, ELEOS CANAL-FILLING STEM| P/N KSP11100E, ELEOS STEM EXTENSION