INFINITY ADAPTIS TIB SZ3LNG INFINITY ADAPTIS
Report
- Report Number
- 3010667733-2024-00718
- Event Type
- Injury
- Date Received
- October 11, 2024
- Date of Event
- January 27, 2022
- Report Date
- December 23, 2024
- Manufacturer
- WRIGHT MEDICAL TECHNOLOGY, INC.
- Product Code
- HSN
- PMA / PMN Number
- K181557
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER
- Health Professional
- N
Narratives
BASED ON THE AVAILABLE INFORMATION THE DEVICE WILL NOT BE RETURNED THEREFORE AN EVALUATION OF THE DEVICE CANNOT BE PERFORMED. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, IT WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.
THE REPORTED EVENT COULD NOT BE CONFIRMED BASED ON AVAILABLE INFORMATION. THE DEVICE INSPECTION WAS NOT POSSIBLE AS THE PRODUCT WAS NOT RETURNED FOR INVESTIGATION. A REVIEW OF THE DEVICE HISTORY FOR THE REPORTED LOT DID NOT INDICATE ANY ABNORMALITIES. NO CORRECTIVE ACTIONS ARE REQUIRED AT THIS TIME. NO INDICATIONS OF MATERIAL, MANUFACTURING OR DESIGN RELATED PROBLEMS WERE FOUND DURING THE INVESTIGATION. A REVIEW OF THE LABELING DID NOT INDICATE ANY ABNORMALITIES. MORE DETAILED INFORMATION ABOUT THE COMPLAINT EVENT AS WELL AS THE AFFECTED DEVICE MUST BE AVAILABLE IN ORDER TO DETERMINE THE ROOT CAUSE OF THE COMPLAINT EVENT. IF DEVICE IS RETURNED OR ANY FURTHER INFORMATION IS PROVIDED, THE INVESTIGATION REPORT WILL BE REASSESSED.
AS REPORTED: "SUBJECT: 200-016 INFINITY¿ WITH ADAPTIS¿ TOTAL ANKLE REPLACEMENT FOLLOW-UP (ITAR2). 27 JAN 2022: FLEXOR HALLUCIS LONGUS LACERATION. INTRA-OPERATIVE LACERATION. AFTER TIBIAL RESECTION COMPLETED AND TIBIAL RESECTION COMPLETED, FHL WAS NOTED TO HAVE SUSTAINED COMPLETE LACERATION AND WAS NOT REPAIRED. 18 JAN 2023: NO COMPLAINTS OR SYMPTOMS VOICED."
AS REPORTED: "SUBJECT: (B)(6) INFINITY¿ WITH ADAPTIS¿ TOTAL ANKLE REPLACEMENT FOLLOW-UP (ITAR2) (B)(6) 2022: FLEXOR HALLUCIS LONGUS LACERATION. INTRA-OPERATIVE LACERATION. AFTER TIBIAL RESECTION COMPLETED AND TIBIAL RESECTION COMPLETED, FHL WAS NOTED TO HAVE SUSTAINED COMPLETE LACERATION AND WAS NOT REPAIRED. (B)(6) 2023: NO COMPLAINTS OR SYMPTOMS VOICED."
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 313622 | INFINITY ADAPTIS TIB SZ3LNG INFINITY ADAPTIS | PROSTHESIS, ANKLE, SEMI-CONSTRAINED, CEMENTED, METAL/POLYMER | HSN | WRIGHT MEDICAL TECHNOLOGY, INC. | 1716255 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 47 YR | Female | Other |