BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LOGIC CC FEMORAL SIZE 3, LEFT

    MDR report key: 19558270 · Received June 18, 2024

    Report

    Report Number
    1038671-2024-01951
    Event Type
    Injury
    Date Received
    June 18, 2024
    Date of Event
    January 9, 2024
    Report Date
    February 26, 2025
    Manufacturer
    EXACTECH, INC.
    Product Code
    JWH
    UDI-DI
    10885862265661
    PMA / PMN Number
    K150890
    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

    D10: (B)(6), 02-022-45-3030, TRULIANT TIB FIT TRAY CEM SZ 3F/3T. (B)(6), 02-012-64-1680, TRU FLUTED STM EXT 16MM X 80MM BLAST. (B)(6), 02-010-06-0531 - TRU POST. AUG. SIZE 3, 5MM. (B)(6), 02-010-06-0531 - TRU POST. AUG. SIZE 3, 5MM. (B)(6), 02-012-61-4000 - TRU OFFSET STEM EXT COUPLER, 4MM. (B)(6), 208-05-03 - CC DISTAL FEM AUGMENT SZ 3, 5MM. 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.

    Additional Manufacturer Narrative · 0

    CORRECTION: PLEASE DISREGARD THIS REPORT AS IT WAS REPORTED IN ERROR. EVENT WAS PREVIOUSLY REPORTED UNDER REPORT #1038671-2024-01428, 1038671-2024-01952, 1038671-2024-01953.

    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, 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
    1613833 LOGIC CC FEMORAL SIZE 3, LEFT PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL JWH EXACTECH, INC. 10885862265661

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Female Hospitalization| R SEE H11