FDA Adverse Event Injury Summary report: N

TRULIANT TIB IMP PSC INSERT SZ 3, 11MM

MDR report key: 19380792 · Received May 23, 2024

Report

Report Number
1038671-2024-01428
Event Type
Injury
Date Received
May 23, 2024
Date of Event
January 9, 2024
Report Date
March 3, 2025
Manufacturer
EXACTECH, INC.
Product Code
JWH
UDI-DI
10885862305091
PMA / PMN Number
K152170
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE REASON FOR THE REVISION REPORTED CANNOT BE CONFIRMED FROM THE INFORMATION PROVIDED BUT MAY BE THE RESULT OF PROSTHESIS WEAR, INSTABILITY, SUBSIDENCE AND LOSS OF RANGE OF MOTION. OR DUE TO INCLUSION OF THE POLYETHYLENE IN THE PACKAGING RECALL. POTENTIAL CONTRIBUTIONS OF USER AND PATIENT-RELATED CONSIDERATIONS TO THE EVENT COULD NOT BE ASSESSED AS THE DEVICES WERE NOT AVAILABLE FOR EVALUATION AND IMAGES AND RADIOGRAPHS WERE NOT PROVIDED.

Additional Manufacturer Narrative · 0

D10: CONCOMITANT DEVICES: 4749579 02-022-45-3030 TRULIANT TIB FIT TRAY CEM SZ 3F / 3T. 5141931 02-012-64-1680 TRU FLUTED STM EXT 16MM X 80MM BLAST. 5565955 02-010-06-0531 - TRU POST. AUG. SIZE 3, 5MM 5783672 02-010-06-0531 - TRU POST. AUG. SIZE 3, 5MM 6061369 02-010-06-0230 - TRU CC FEMORAL SIZE 3 LEFT 6104282 02-012-61-4000 - TRU OFFSET STEM EXT COUPLER, 4MM. 6126015 208-05-03 - CC DISTAL FEM AUGMENT SZ 3, 5MM. THE PRODUCT ASSOCIATED WITH THE REPORTED EVENT IS WITHIN THE SCOPE OF RECALL Z-0023-2022; HOWEVER, THERE IS INSUFFICIENT INFORMATION TO EVALUATE WHETHER THE SUBJECT ISSUE OF THE RECALL WAS THE CAUSE OR CONTRIBUTOR TO THE REPORTED EVENT. THE DEVICE WAS NOT RETURNED FOR EVALUATION AND NO MEDICAL OR OTHER RECORDS CONTAINING TREATMENT INFORMATION OR PATIENT INFORMATION HAVE BEEN RECEIVED; THEREFORE, THE REPORTED EVENT CANNOT BE CONFIRMED, NOR CAN THE CIRCUMSTANCES OR POTENTIAL CAUSES OR CONTRIBUTORS TO THE ALLEGED EVENT BE EVALUATED. SHOULD ADDITIONAL MATERIAL INFORMATION BECOME AVAILABLE THAT PERMITS MORE ANALYSIS OR CONCLUSIONS, A SUPPLEMENTAL REPORT WILL BE FILED ACCORDINGLY.

Description of Event or Problem · 0

IT WAS REPORTED THAT APPROXIMATELY 52 MONTHS AFTER A LEFT TOTAL KNEE REPLACEMENT PROCEDURE, THE PATIENT UNDERWENT A REVISION PROCEDURE TO ADDRESS PROSTHESIS WEAR, STIFFNESS, INCREASED PAIN, ARTHRITIS, AND SCARRING. REVISION SURGERY OPERATIVE NOTES WERE PROVIDED. PATIENT LEFT THE OPERATING ROOM IN STABLE CONDITION. POST OPERATIVE DIAGNOSIS NOTED WEAR OF THE IMPLANT. NO FURTHER ISSUES OR COMPLICATIONS WERE REPORTED. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1609317 TRULIANT TIB IMP PSC INSERT SZ 3, 11MM PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL JWH EXACTECH, INC. 10885862305091

Patients

Seq Age Sex Outcome Treatment
1 61 YR Female Required Intervention| H SEE H10