FDA Adverse Event Other Summary report: N

FOUNDATION KNEE

MDR report key: 1853236 · Received September 30, 2010

Report

Report Number
1644408-2010-00515
Event Type
Other
Date Received
September 30, 2010
Date of Event
September 21, 2010
Report Date
September 21, 2010
Manufacturer
ENCORE MEDICAL, L.P.
Product Code
JWH
PMA / PMN Number
K923277
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
RI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

REVISION SURGERY - THE PT HAD A KNEE INFECTION, THE SURGEON REMOVED THE ANTIBIOTIC SPACER AND INSERTED NEW DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FOUNDATION KNEE PRIMARY INSERT, 500 SERIES JWH ENCORE MEDICAL, L.P. 53867058

Patients

Seq Age Sex Outcome Treatment
1 68 YR Required Intervention