FDA Adverse Event Injury Summary report: N

OPTETRAK LOGIC

MDR report key: 19651792 · Received July 1, 2024

Report

Report Number
1038671-2024-02245
Event Type
Injury
Date Received
July 1, 2024
Date of Event
June 25, 2024
Report Date
October 27, 2024
Manufacturer
EXACTECH, INC.
Product Code
JWH
UDI-DI
10885862230409
PMA / PMN Number
K123342
Removal / Correction Number
Z-0021-2022
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

D10: CONCOMITANTS: 5743276 02-010-04-0230 - LOGIC CR FEMORAL POR, LEFT, SZ 3. 6289327 02-012-45-3030 - LGC TIBIAL FIT TRAY CEM SZ 3F / 3T. 6757428 201-78-15 - HOLDING PIN MINI SHARP POINT 4 PK. 6557836 201-78-81 - 3 TROCAR, MOD. HEX 2PK. S103825 521-78-23 - THREADED PIN SIZE 2.3 COLLARED. S125864 521-78-23 - THREADED PIN SIZE 2.3 COLLARED. S007882 521-78-32 - THREADED PIN SIZE 3.0 COLLARLESS. 09000320004 A10012 - GPS IMPLANT KIT V2.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: H3: THE REVISION REPORTED WAS LIKELY THE RESULT OF INFECTION, COMPONENT LOOSENING, AND PROSTHESIS WEAR. HOWEVER, THE REPORTED WEAR OF THE PATELLA COULD NOT BE CONFIRMED. THE REPORTED CELLULITIS MAY HAVE LED TO THE INFECTION OF THE PATIENT¿S KNEE, RESULTING IN LOOSENING AND SUBSEQUENT THIRD BODY WEAR; HOWEVER, THE SEQUENCE OF EVENTS AND THE LIKELY CAUSE OF THE INFECTION, LOOSENING, AND INSERT WEAR COULD NOT BE CONFIRMED AS THE DEVICES WERE NOT RETURNED FOR EVALUATION. H6: HEALTH EFFECT-CLINICAL CODE, COMPONENT CODE, INVESTIGATION CODES

Description of Event or Problem · 0

IT WAS REPORTED THAT APPROXIMATELY 42 MONTHS AFTER A LEFT TOTAL KNEE REPLACEMENT PROCEDURE, THE PATIENT UNDERWENT A REVISION PROCEDURE TO ADDRESS PROSTHESIS WEAR OF THE TIBIAL INSERT AND PATELLAR COMPONENT. NO FURTHER ISSUES OR COMPLICATIONS WERE REPORTED. PATIENT WAS LAST KNOWN TO BE IN STABLE CONDITION FOLLOWING THE EVENT. DEVICE IMAGES AND X-RAYS WERE PROVIDED. THE EXPLANTED DEVICES WERE DISPOSED OF BY THE HOSPITAL. NO ADDITIONAL INFORMATION IS AVAILABLE.

Description of Event or Problem · 0

EVERYTHING WAS REVISED. LEGAL NOTIFICATION RECEIVED. CLINICAL DETAILS: INITIAL LEFT TKR ON (B)(6) 2021. KNOWN POLY OXIDATION RISK, POPLITEAL CYST, SYNOVITIS. HAD SIGNIFICANT EPISODE OF CELLULITIS IN 2023 REQUIRING INTRAVENOUS ANTIBIOTICS. POSSIBLE SOURCE OF INOCULATION. CLINICALLY INFECTED TKR. ELEVATED CRP, WARM SWOLLEN, PAINFUL AND POSITIVE BONE SCAN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
571889 OPTETRAK LOGIC PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL JWH EXACTECH, INC. 10885862230409

Patients

Seq Age Sex Outcome Treatment
1 88 YR Female Required Intervention SEE H11.