FDA Adverse Event Other Summary report: N

3D KNEE

MDR report key: 2001096 · Received February 16, 2011

Report

Report Number
1644408-2011-00077
Event Type
Other
Date Received
February 16, 2011
Date of Event
February 5, 2011
Report Date
February 5, 2011
Manufacturer
ENCORE MEDICAL, L.P.
Product Code
JWH
PMA / PMN Number
K020114
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

REVISION SURGERY -THE PT HAD AN INFECTION. THE SURGEON WASHED OUT AND REPLACED THE INSERT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 3D KNEE DCM TIBIAL INSERT JWH ENCORE MEDICAL, L.P. 54034895

Patients

Seq Age Sex Outcome Treatment
1 65 YR Required Intervention