FDA Adverse Event Injury Summary report: N

VSP ORTHOPAEDICS

MDR report key: 13696983 · Received March 8, 2022

Report

Report Number
1724955-2022-00003
Event Type
Injury
Date Received
March 8, 2022
Date of Event
February 15, 2022
Report Date
February 24, 2022
Manufacturer
3D SYSTEMS
Product Code
PBF
UDI-DI
00816847022453
PMA / PMN Number
K190044
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

3D SYSTEMS INVESTIGATION IS ONGOING, NO ROOT CAUSE HAS BEEN DETERMINED AT THIS TIME. SURGERY WAS SUCCESSFUL AND NO ADVERSE EVENTS WERE REPORTED.

Description of Event or Problem · 0

DURING A VSP ORTHOPAEDICS TIBIA RESECTION AND ALLOGRAFT RECONSTRUCTION PROCEDURE, THE GUIDES PROVIDED BY 3D SYSTEMS DID NOT PRODUCE AN ACCURATE REPRESENTATION OF THE PLANNED ALLOGRAFT USED IN SURGERY. THE SURGEON NOTED THAT THE PHYSICAL ALLOGRAFT AND THE ALLOGRAFT MODEL WERE MIRRORED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2632053 VSP ORTHOPAEDICS TIBIA ALLOGRAFT CUTTING GUIDE PBF 3D SYSTEMS Allograft Orthopedic Model 162603 00816847022453

Patients

Seq Age Sex Outcome Treatment
1 26 YR Female Other