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