FDA Adverse Event Other Summary report: N

3D KNEE

MDR report key: 2011687 · Received March 1, 2011

Report

Report Number
1644408-2011-00120
Event Type
Other
Date Received
March 1, 2011
Date of Event
February 24, 2011
Report Date
February 24, 2011
Manufacturer
ENCORE MEDICAL, L.P.
Product Code
JWH
PMA / PMN Number
K020114
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

REVISION SURGERY - THE KNEE WAS INFECTED AND THE SURGEON PERFORMED A POLY EXCHANGE DURING THE WASH OUT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 3D KNEE DCM TIBIAL KNEE INSERT JWH ENCORE MEDICAL, L.P. 54057755

Patients

Seq Age Sex Outcome Treatment
1 57 YR Required Intervention