FDA Adverse Event Injury Summary report: N

ATTUN REV OFFST STM ADPTR 4MM

MDR report key: 14655607 · Received June 10, 2022

Report

Report Number
1818910-2022-10657
Event Type
Injury
Date Received
June 10, 2022
Date of Event
May 1, 2021
Report Date
June 10, 2022
Manufacturer
DEPUY IRELAND - 9616671
Product Code
JWH
UDI-DI
10603295475132
PMA / PMN Number
P830055
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4). INVESTIGATION SUMMARY: NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. THE INFORMATION RECEIVED WILL BE RETAINED FOR POTENTIAL SERIES INVESTIGATIONS IF TRIGGERED BY TREND ANALYSIS, POST MARKET SURVEILLANCE, OR OTHER EVENTS WITHIN THE QUALITY SYSTEM. DEPUY CONSIDERS THE INVESTIGATION CLOSED. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION WILL BE RE-OPENED AS NECESSARY. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 0

SUBJECT ID: (B)(6). STUDY: DSJ-2016-02 NEW, NEW CLINICAL ADVERSE EVENT RECEIVED FOR RIGHT KNEE LIMITED RANGE OF MOTION. EVENT IS SERIOUS AND IS CONSIDERED MODERATE. EVENT IS POSSIBLY RELATED TO BOTH DEVICE AND PROCEDURE. DATE OF IMPLANT: (B)(6) 2021. DATE OF EVENT: UNK (B)(6) 2021. AFFECTED SIDE: (RIGHT KNEE). TREATMENT: AWAITING MANIPULATION UNDER ANESTHESIA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
630660 ATTUN REV OFFST STM ADPTR 4MM KNEE STEMS JWH DEPUY IRELAND - 9616671 1513-04-000 8923424 10603295475132

Patients

Seq Age Sex Outcome Treatment
1 71 YR Female ATTUN REV OFFST STM ADPTR 4MM| ATTUN REV OFFST STM ADPTR 4MM| ATTUNE CRS FB INSRT SZ 7 16MM| ATTUNE CRS FEMORAL RT SZ 7 CEM| ATTUNE DIST FEM AUG SZ 7 4MM| ATTUNE DIST FEM AUG SZ 7 4MM| ATTUNE MEDIAL DOME PAT 38MM| ATTUNE POS FEM AUG SZ 7 8MM| ATTUNE POS FEM AUG SZ 7 8MM| ATUN PRESSFIT STR STEM24X110MM| ATUNE CRS FB TIB BASE SZ 6 CEM| ATUNE PRESSFIT STR STEM22X60MM| COMPETITOR CEMENT MANUFACTURER (STRYKER)| COMPETITOR CEMENT MANUFACTURER (STRYKER)