FDA Adverse Event Injury Summary report: N

TRULIANT TIB IMP CR INS STD SZ 4.5, 9MM

MDR report key: 19927372 · Received August 7, 2024

Report

Report Number
1038671-2024-02717
Event Type
Injury
Date Received
August 7, 2024
Date of Event
April 14, 2022
Report Date
February 10, 2025
Manufacturer
EXACTECH, INC.
Product Code
JWH
UDI-DI
10885862306524
PMA / PMN Number
K171045
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

D10 CONCOMITANT DEVICES (B)(6), 200-02-35 - THREE PEG PATELLA 35MM. (B)(6), 02-020-13-0345 - TRULIANT CR CEM FEM CR CEM RIGHT SZ 4.5. (B)(6), 02-022-45-4545 - TRULIANT TIB FIT TRAY CEM SZ 4.5F/4.5T. THE PRODUCT ASSOCIATED WITH THE REPORTED EVENT IS WITHIN THE SCOPE OF RECALL 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

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. D4: CORRECTED. G4: CORRECTED. H6: CORRECTED HEALTH EFFECT AND INVESTIGATION CLINICAL CODES.

Description of Event or Problem · 0

IT WAS REPORTED VIA LEGAL DOCUMENTATION THAT APPROXIMATELY 36 MONTHS AFTER A RIGHT TOTAL KNEE REPLACEMENT PROCEDURE, THE PATIENT UNDERWENT A REVISION PROCEDURE TO ADDRESS PROSTHESIS WEAR. NO FURTHER ISSUES OR COMPLICATIONS WERE REPORTED. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
221404 TRULIANT TIB IMP CR INS STD SZ 4.5, 9MM PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL JWH EXACTECH, INC. TRULIANT TIB IMP CR INS STD SZ 4.5, 9MM 10885862306524

Patients

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