FDA Adverse Event Other Summary report: N

PATELLA

MDR report key: 1843844 · Received September 21, 2010

Report

Report Number
1038671-2010-00137
Event Type
Other
Date Received
September 21, 2010
Date of Event
August 10, 2010
Report Date
September 21, 2010
Manufacturer
EXACTECH INC
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ENGINEERING EVAL OF THE RETURNED PATELLA NOTED THAT THE PEG HAD BEEN CUT OFF AND THERE WERE MARKS ON THE BACKSIDE CONSISTENT WITH A SAW BLADE BEING USED TO REMOVE THE DEVICE. THE ARTICULAR SURFACE OF THE DEVICE HAD OFF CENTER DEFORMATION WITH AN EDGE FORMING NEAR THE DEFORMATION.

Description of Event or Problem · 1

REVISION OF TOTAL KNEE ARTHROPLASTY DUE TO PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PATELLA JWH EXACTECH INC

Patients

Seq Age Sex Outcome Treatment
1 78 YR Required Intervention