FDA Adverse Event
Injury
Summary report: N
EVOLUTION® MP? CS INSERT SIZE 6 STANDARD 10MM RIGH
MDR report key: 22681604
·
Received July 31, 2025
Report
- Report Number
- 3010536692-2025-00293
- Event Type
- Injury
- Date Received
- July 31, 2025
- Report Date
- July 31, 2025
- Manufacturer
- MICROPORT ORTHOPEDICS INC.
- Product Code
- HRY
- UDI-DI
- M684EIS6S10R1
- PMA / PMN Number
- K093552
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- UK
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
ALLEGEDLY, PATIENT WAS REVISED DUE TO INFECTION. SRNJR NUMBER: (B)(6). SIDE: R. NON-REVISED PRODUCTS: PRODUCT ID: EFSRN6PR EVOLUTION® MP FEM CS/CR NON-POROUS SIZE 6 PRIMARY RIGHT/ LOT NO.: 2007053/ QTY: 1. PRODUCT ID: ETPKN6SR EVOLUTION® MP TIBIAL BASE KEELED NON-POROUS SIZE 6 STANDARD RIGHT/ LOT NO.: 2030828/ QTY: 1. PRODUCT ID: KPONTP35 ADVANCE® ONLAY ALL-POLY PATELLA 35MM TRI-PEG/ LOT NO.: 20284692032763/ QTY: 1.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 221626 | EVOLUTION® MP? CS INSERT SIZE 6 STANDARD 10MM RIGH | KNEE COMPONENT | HRY | MICROPORT ORTHOPEDICS INC. | EIS6S10R | 2032001 | M684EIS6S10R1 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 80 YR | Male | Required Intervention |