FDA Adverse Event Injury Summary report: N

LOGIC KNEE COMPONENTS

MDR report key: 20451404 · Received October 15, 2024

Report

Report Number
1038671-2024-03981
Event Type
Injury
Date Received
October 15, 2024
Date of Event
July 16, 2013
Report Date
October 15, 2024
Manufacturer
EXACTECH, INC.
Product Code
JWH
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

D10: CONCOMITANT DEVICES: 2382678 201-78-11 - HOLDING PIN SMALL HEADED SHORT 4 PACK. 2596712 02-012-45-2525 - LGC TIBIAL FIT TRAY CEM SZ 2.5F / 2.5T. 2625448 02-010-01-0325 - LOGIC FEMORAL PS CEM RIGHT SZ 2.5. 2680986 200-02-29 - THREE PEG PATELLA 29MM. AA6828 13A2101 - CEMEX SYSTEM FAST GENTA 70G. 2143056 02-012-35-2511 - LOGIC TIBIA PS MOD INSRT SZ 2.5 11MM. 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

IT WAS REPORTED VIA LEGAL DOCUMENTATION THAT APPROXIMATELY 116 MONTHS AFTER A RIGHT KNEE REPLACEMENT PROCEDURE, THE PATIENT UNDERWENT A REVISION PROCEDURE TO ADDRESS PROSTHESIS WEAR, KNEE PAIN, SWELLING, EXACTECH KNEE IMPLANT UNSTABLE, AND KNEE COMPONENT LOOSENING. NO FURTHER ISSUES OR COMPLICATIONS WERE REPORTED. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
32744 LOGIC KNEE COMPONENTS LOGIC KNEE JWH EXACTECH, INC.

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention| H SEE H10.