FDA Adverse Event Injury Summary report: N

TRULIANT TIB IMP CRC INSERT SZ 3.5, 11MM

MDR report key: 19918980 · Received August 6, 2024

Report

Report Number
1038671-2024-02703
Event Type
Injury
Date Received
August 6, 2024
Date of Event
September 12, 2023
Report Date
November 1, 2024
Manufacturer
EXACTECH, INC.
Product Code
JWH
UDI-DI
10885862307705
PMA / PMN Number
K152170
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

D10: CONCOMITANT DEVICES: (6545521) 02-020-13-0335 - TRULIANT CR CEM FEM CR CEM RIGHT SZ 3.5. (7004919) 200-07-35 - ADVANCED PATELLA 35MM 3 PEG IMPLANT. 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 A 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.

Additional Manufacturer Narrative · 0

H6: CORRECTED THE FOLLOWING: TYPE OF INVESTIGATION. THE REASON FOR THE REVISION REPORTED CANNOT BE CONFIRMED FROM THE INFORMATION PROVIDED BUT MAY BE THE RESULT OF PROSTHESIS WEAR 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, RADIOGRAPHS, AND RELEVANT CLINICAL INFORMATION WERE NOT PROVIDED.

Description of Event or Problem · 0

IT WAS REPORTED VIA LEGAL DOCUMENTATION THAT APPROXIMATELY 20 MONTHS AFTER A RIGHT TOTAL KNEE REPLACEMENT PROCEDURE, THE PATIENT UNDERWENT A REVISION PROCEDURE TO ADDRESS PROSTHESIS WEAR, DEGENERATIVE JOINT DISEASE, PAIN, DISCOMFORT, SWELLING, MOTION RESTRICTION, DIFFICULTY WITH AMBULATION AND PERFORMING SIMPLE ACTIVITIES OF DAILY LIVING, FINANCIAL HARDSHIP. NO FURTHER ISSUES OR COMPLICATIONS WERE REPORTED. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1703421 TRULIANT TIB IMP CRC INSERT SZ 3.5, 11MM PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL JWH EXACTECH, INC. 10885862307705

Patients

Seq Age Sex Outcome Treatment
1 NA Male Required Intervention| H SEE H11.