FDA Adverse Event Injury Summary report: N

OPTETRAK LOGIC

MDR report key: 21454357 · Received February 24, 2025

Report

Report Number
1038671-2025-01175
Event Type
Injury
Date Received
February 24, 2025
Date of Event
January 30, 2025
Report Date
March 18, 2025
Manufacturer
EXACTECH, INC.
Product Code
JWH
UDI-DI
10885862144416
PMA / PMN Number
K111400
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE REASON FOR THE REVISION REPORTED CANNOT BE CONFIRMED FROM THE INFORMATION PROVIDED BUT MAY BE THE RESULT OF PROSTHESIS WEAR OR DUE TO INCLUSION OF THE POLYETHYLENE IN THE PACKAGING RECALL. POTENTIAL CONTRIBUTIONS OF USER AND PATIENT-RELATED CONSIDERATIONS TO THE EVENT COULD NOT BE ASSESSED AS THE DEVICES WERE NOT AVAILABLE FOR EVALUATION AND RADIOGRAPHS AND RELEVANT CLINICAL INFORMATION WERE NOT PROVIDED. H6: CORRECTED INVESTIGATION CLINICAL CODES.

Additional Manufacturer Narrative · 0

D10: CONCOMITANTS: 4022859 02-010-03-0215 - LOGIC CR FEMORAL CEM, LEFT SZ 1.5. 2576188 02-012-45-1525 - LGC TIBIAL FIT TRAY CEM SZ 1.5F / 2.5T. SHOULD ADDITIONAL RELEVANT INFORMATION BE OBTAINED, A FOLLOW-UP MDR WILL BE SUBMITTED ACCORDINGLY.

Description of Event or Problem · 0

IT WAS REPORTED A 80 YO FEMALE PATIENT HAD AN ORIGINAL LEFT TKA. THE PATIENT RETURNED TO THE SURGEON'S OFFICE WITH COMPLAINTS OF STIFFNESS, PAIN, AND DISSATISFACTION WITH THEIR TOTAL KNEE REPLACEMENT. THE PATIENT HAS A RECALLED POLYETHYLENE IMPLANT. THE PATIENT WAS SCHEDULED FOR A REVISION TKA POSSIBLE POLYETHYLENE SWAP. THE PATIENT HAD REVISION SURGERY IN (B)(6) 2025. THE PATIENT UNDERWENT A TIBIAL POLYETHYLENE IMPLANT SWAP AND A PATELLA IMPLANT SWAP. THERE WERE NO SURGICAL DELAYS OR DEVICE BREAKAGES DURING THE PROCEDURE. THE PATIENT WAS LAST KNOWN TO BE IN STABLE CONDITION FOLLOWING THE EVENT. NO X-RAYS WERE AVAILABLE. THE EXPLANTED DEVICES ARE NOT AVAILABLE FOR RETURN. THEY WERE SENT TO THE LAB AT THE HOSPITAL. DEVICE IMAGES WERE PROVIDED. NO FURTHER INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1472241 OPTETRAK LOGIC PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL JWH EXACTECH, INC. 10885862144416

Patients

Seq Age Sex Outcome Treatment
1 80 YR Female Required Intervention SEE H11.