FDA Adverse Event Other Summary report: N

3D KNEE

MDR report key: 1880549 · Received October 19, 2010

Report

Report Number
1644408-2010-00553
Event Type
Other
Date Received
October 19, 2010
Date of Event
September 20, 2010
Report Date
September 20, 2010
Manufacturer
ENCORE MEDICAL, L.P.
Product Code
JWH
PMA / PMN Number
K020114
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

REVISION SURGERY - PT'S KNEE WAS ASPIRATED DUE TO (B)(6) GROWING OUT OF THE ASPIRATION. AFTER CLEANING UP THE INFECTED AREA, SURGEON PERFORMED A POLY SWAP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 3D KNEE TIBIAL INSERT JWH ENCORE MEDICAL, L.P. 433202

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention