FDA Adverse Event Injury Summary report: N

TORNIER PERFORM ANATOMIC AUG MED RIGHT GLENOID 15 DG

MDR report key: 18870883 · Received March 8, 2024

Report

Report Number
0001649390-2024-00105
Event Type
Injury
Date Received
March 8, 2024
Date of Event
February 7, 2024
Report Date
April 11, 2024
Manufacturer
TORNIER INC
Product Code
KWS
UDI-DI
00846832089048
PMA / PMN Number
K150583
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

CORRECTION: D4 CATALOG #, D1(PRODUCT LONG DESCRIPTION), D4 GTIN. THE REPORTED EVENT WAS NOT CONFIRMED, BASED ON THE AVAILABLE X-RAY AND MEDICAL EXPERT OPINION. THE DEVICE INSPECTION WAS NOT POSSIBLE AS THE PRODUCT WAS NOT RETURNED FOR INVESTIGATION. A REVIEW OF THE X-RAYS BY THE MEDICAL EXPERT STATED; ¿THE ALLEGED FAILURE RELATES TO SENSORY LOSS IN THE AREA OF THE MEDIAN NERVE. SINCE THE DEVICE IS INTACT, THERE IS NO DEVICE RELATED PROBLEM. SINCE NO TIMELINE IS GIVEN, AND THERE IS NO MENTIONING OF MOTOR-LOSS, THIS EVENT DOES NOT NECESSARILY HAS TO BE RELATED TO THE PROCEDURE. (I.E., CARPAL TUNNEL SYNDROME AT THE LEVEL OF THE WRIST). IN ORDER TO DETERMINE REASON BEHIND THE ALLEGED FAILURE A MORE DETAILED INFORMATION ON TIMELINE WOULD BE REQUIRED.¿ THE DEVICE HISTORY RECORD COULD NOT BE REVIEWED BECAUSE THE AFFECTED DEVICE WAS NOT RETURNED, AND THE LOT NUMBER WAS NOT COMMUNICATED. INDICATIONS OF MATERIAL, MANUFACTURING, OR DESIGN RELATED PROBLEMS WERE UNABLE TO BE IDENTIFIED AS THE LOT NUMBER WAS NOT COMMUNICATED. A REVIEW OF THE LABELING DID NOT INDICATE ANY ABNORMALITIES. MORE DETAILED INFORMATION ABOUT THE COMPLAINT EVENT AS WELL AS THE AFFECTED DEVICE MUST BE AVAILABLE IN ORDER TO DETERMINE THE EXACT ROOT CAUSE OF THE COMPLAINT EVENT. IF THE DEVICE IS RETURNED OR IF ANY ADDITIONAL INFORMATION IS PROVIDED, THE INVESTIGATION WILL BE REASSESSED.

Additional Manufacturer Narrative · 0

THIS DEVICE WAS NOT CLEARED IN THE US; HOWEVER, A SIMILAR DEVICE WAS CLEARED UNDER 510K # K150583. THE REPORTED EVENT WAS NOT CONFIRMED, BASED ON THE AVAILABLE X-RAY AND MEDICAL EXPERT OPINION. THE DEVICE INSPECTION WAS NOT POSSIBLE AS THE PRODUCT WAS NOT RETURNED FOR INVESTIGATION. A REVIEW OF THE X-RAYS BY THE MEDICAL EXPERT STATED; ¿THE ALLEGED FAILURE RELATES TO SENSORY LOSS IN THE AREA OF THE MEDIAN NERVE. SINCE THE DEVICE IS INTACT, THERE IS NO DEVICE RELATED PROBLEM. SINCE NO TIMELINE IS GIVEN, AND THERE IS NO MENTIONING OF MOTOR-LOSS, THIS EVENT DOES NOT NECESSARILY HAS TO BE RELATED TO THE PROCEDURE. (I.E., CARPAL TUNNEL SYNDROME AT THE LEVEL OF THE WRIST). IN ORDER TO DETERMINE REASON BEHIND THE ALLEGED FAILURE A MORE DETAILED INFORMATION ON TIMELINE WOULD BE REQUIRED.¿ THE DEVICE HISTORY RECORD COULD NOT BE REVIEWED BECAUSE THE AFFECTED DEVICE WAS NOT RETURNED, AND THE LOT NUMBER WAS NOT COMMUNICATED. INDICATIONS OF MATERIAL, MANUFACTURING, OR DESIGN RELATED PROBLEMS WERE UNABLE TO BE IDENTIFIED AS THE LOT NUMBER WAS NOT COMMUNICATED. A REVIEW OF THE LABELING DID NOT INDICATE ANY ABNORMALITIES. MORE DETAILED INFORMATION ABOUT THE COMPLAINT EVENT AS WELL AS THE AFFECTED DEVICE MUST BE AVAILABLE IN ORDER TO DETERMINE THE EXACT ROOT CAUSE OF THE COMPLAINT EVENT. IF THE DEVICE IS RETURNED OR IF ANY ADDITIONAL INFORMATION IS PROVIDED, THE INVESTIGATION WILL BE REASSESSED. H3 OTHER TEXT : DEVICE DISPOSITION UNKNOWN.

Description of Event or Problem · 0

SUBJECT REPORTS EXPERIENCING NUMBNESS IN FINGERS, ACCOMPANIED BY DECREASED SENSATION AND WEAKNESS IN THE THUMB, INDEX, AND MIDDLE FINGERS.

Description of Event or Problem · 0

SUBJECT REPORTS EXPERIENCING NUMBNESS IN FINGERS, ACCOMPANIED BY DECREASED SENSATION AND WEAKNESS IN THE THUMB, INDEX, AND MIDDLE FINGERS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
159186 TORNIER PERFORM ANATOMIC AUG MED RIGHT GLENOID 15 DG PROSTHESIS, SHOULDER, SEMI-CONSTRAINED, METAL/POLYMER CEMENTED KWS TORNIER INC UNKNOWN 00846832089048

Patients

Seq Age Sex Outcome Treatment
1 60 YR Female Other