FDA Adverse Event Injury Summary report: N

ATTUNE RP TIB BASE SZ 8 CEM

MDR report key: 19992154 · Received August 15, 2024

Report

Report Number
1818910-2024-17491
Event Type
Injury
Date Received
August 15, 2024
Date of Event
August 5, 2024
Report Date
August 15, 2024
Manufacturer
DEPUY IRELAND - 9616671
Product Code
NJL
UDI-DI
10603295492207
PMA / PMN Number
P830055
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT # (B)(4). THIS REPORT IS BEING SUBMITTED PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803 (AND/OR PART 4, AS APPLICABLE). THIS REPORT MAY BE BASED ON INFORMATION WHICH HAS NOT BEEN INVESTIGATED OR VERIFIED PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY DEPUY SYNTHES, OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE PRODUCT, DEPUY SYNTHES, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 0

PRODUCT COMPLAINT (B)(4). INVESTIGATION SUMMARY: NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. A MANUFACTURING RECORD EVALUATION (NC SEARCH) WAS PERFORMED FOR THE FINISHED DEVICE PRODUCT CODE:150680008, LOT:4062201 AND NO NON-CONFORMANCES / MANUFACTURING IRREGULARITIES WERE IDENTIFIED. AS PART OF OUR COMPANY QUALITY SYSTEM PROCESS, ALL DEVICES ARE MANUFACTURED, INSPECTED, AND DISTRIBUTED TO APPROVED SPECIFICATIONS. ADDITIONAL COMPLAINT INFORMATION MONITORING FOR POTENTIAL SAFETY SIGNALS WILL BE CONDUCTED THROUGH COMPLAINT TRENDING AS PART OF THE POST-MARKET SURVEILLANCE. IF ADDITIONAL INFORMATION IS MADE AVAILABLE, THE INVESTIGATION WILL BE UPDATED AS APPLICABLE. DEVICE HISTORY LOT: A MANUFACTURING RECORD EVALUATION (NC SEARCH) WAS PERFORMED FOR THE FINISHED DEVICE PRODUCT CODE:150680008, LOT:4062201 AND NO NON-CONFORMANCES / MANUFACTURING IRREGULARITIES WERE IDENTIFIED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT PRESENTED WITH CHRONIC DRAINAGE FROM KNEE AND SCHEDULED FOR IRRIGATION AND DEBRIDEMENT (I&D) WITH HARDWARE REMOVAL ON (B)(6) 2024. DOI: (B)(6) 2024. DOE: (B)(6) 2024. AFFECTED SIDE: LEFT KNEE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1620722 ATTUNE RP TIB BASE SZ 8 CEM KNEE TIBIAL TRAY NJL DEPUY IRELAND - 9616671 4062201 10603295492207

Patients

Seq Age Sex Outcome Treatment
1 61 YR Male Required Intervention ATTUNE MEDIAL ANAT PAT 35MM.| ATTUNE PS FEM LT SZ 7 CEM.| ATTUNE PS RP INSRT SZ 7 10MM.