FDA Adverse Event Injury Summary report: N

TRULIANT TIB IMP PS INSERT SZ 2.5 10MM

MDR report key: 20177586 · Received September 9, 2024

Report

Report Number
1038671-2024-03397
Event Type
Injury
Date Received
September 9, 2024
Date of Event
June 3, 2020
Report Date
September 9, 2024
Manufacturer
EXACTECH, INC.
Product Code
JWH
UDI-DI
10885862304179
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

CONCOMITANTS: (B)(6) 200-02-35 - THREE PEG PATELLA 35MM (B)(6) 02-022-45-2525 - TRULIANT TIB FIT TRAY CEM SZ 2.5F / 2.5T (B)(6) 02-020-11-0225 - TRULIANT PS CEM FEM PS CEM LEFT SZ 2.5 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.

Description of Event or Problem · 0

LEGAL CASE ¿ USA (MDL NO. 3044) (NGG) (MMH) REFER TO CASE-(B)(4) FOR LK CURRENT. IT WAS REPORTED VIA LEGAL DOCUMENTATION THAT APPROXIMATELY 28 MONTHS AFTER A LEFT TOTAL KNEE REPLACEMENT PROCEDURE, THE PATIENT HAS EXPERIENCED PROSTHESIS WEAR, PAIN, STIFFNESS, DISCOMFORT, AFFECTED MOBILITY. NO FURTHER ISSUES OR COMPLICATIONS WERE REPORTED. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
253200 TRULIANT TIB IMP PS INSERT SZ 2.5 10MM PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL JWH EXACTECH, INC. UNK 10885862304179

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Hospitalization| R SEE H11