FDA Adverse Event Injury Summary report: N

TRULIANT TIB FIT TRAY CEM SZ 3F / 3T

MDR report key: 19558470 · Received June 18, 2024

Report

Report Number
1038671-2024-01953
Event Type
Injury
Date Received
June 18, 2024
Date of Event
January 9, 2024
Report Date
March 3, 2025
Manufacturer
EXACTECH, INC.
Product Code
JWH
UDI-DI
10885862305824
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

D10: 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 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

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. H6: CORRECTED HEALTH EFFECT, MEDICAL DEVICE, COMPONENT, AND INVESTIGATION CLINICAL CODES.

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
2315660 TRULIANT TIB FIT TRAY CEM SZ 3F / 3T PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL JWH EXACTECH, INC. 10885862305824

Patients

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