FDA Adverse Event Malfunction Summary report: N

LINK MITUS ENDO-MODEL

MDR report key: 2193484 · Received July 29, 2011

Report

Report Number
9610548-2011-00021
Event Type
Malfunction
Date Received
July 29, 2011
Date of Event
November 19, 2008
Report Date
July 29, 2011
Manufacturer
WALDEMAR LINK GMBH & CO. KG
Product Code
HSX
PMA / PMN Number
K954186
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE UHMWPE TIBIA PLATEAU SHOWS STRONG WEAR, WHICH IS NOT LOCATED IN THE MIDDLE OF THE PLATEAU AND LEADS TO THE ASSUMPTION THAT THE IMPLANT WAS NOT ALIGNED CORRECTLY TO THE ANATOMICAL STRUCTURES OF THE PT. BESIDE THIS, THE PT IS OBESE. THIS EVENT OCCURRED OUTSIDE THE U.S. AND INVOLVED A PRODUCT THAT WAS MFG OUTSIDE OF THE U.S. HOWEVER, BECAUSE THE LINK MITUS ENDO-MODEL ALSO IS MARKETED IN THE U.S. LINK IS SUBMITTING THIS MDR TO ENSURE FULL COMPLIANCE WITH 21 CFR PART 803.

Description of Event or Problem · 1

STRONG WEAR OF PE INSERT AFTER ONE YEAR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LINK MITUS ENDO-MODEL SLED OR UNI-COMPARTMENT PROSHESIS HSX WALDEMAR LINK GMBH & CO. KG 15-2030/11

Patients

Seq Age Sex Outcome Treatment
1 47 YR Hospitalization