FDA Adverse Event Injury Summary report: N

GMK-HINGE FIXED TIBIAL INSERT SIZE 3/20MM

MDR report key: 19836852 · Received July 26, 2024

Report

Report Number
3005180920-2024-00546
Event Type
Injury
Date Received
July 26, 2024
Date of Event
June 26, 2024
Report Date
July 26, 2024
Manufacturer
MEDACTA INTERNATIONAL SA
Product Code
KRO
UDI-DI
07630030825156
PMA / PMN Number
K130299
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

BATCH REVIEW PERFORMED ON 02-JUL-2024. LOT 2246199: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 09-MAR-2023. EXPIRATION DATE: 2028-02-20. NO ANOMALIES FOUND RELATED TO THE PROBLEM. TO DATE, (B)(4) ITEMS OF THE SAME LOT HAVE BEEN SOLD WITH NO SIMILAR REPORTED EVENT DURING THE PERIOD OF REVIEW.

Description of Event or Problem · 0

AT ABOUT 1 MONTH AFTER PRIMARY, THE PATIENT CAME IN DUE TO SIGNS OF AN INFECTION AND THE PATHOGEN IS UNKNOWN. THE SURGEON PERFORMED A WASHOUT AND REVISED THE LINER. THE SURGERY WAS COMPLETED SUCCESSFULLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1776934 GMK-HINGE FIXED TIBIAL INSERT SIZE 3/20MM KNEE TIBIAL INSERT KRO MEDACTA INTERNATIONAL SA 2246199 07630030825156

Patients

Seq Age Sex Outcome Treatment
1 68 YR Female Required Intervention