FDA Adverse Event
Malfunction
Summary report: N
MISHA KNEE SYSTEM
MDR report key: 23011837
·
Received September 9, 2025
Report
- Report Number
- 3008274656-2025-00004
- Event Type
- Malfunction
- Date Received
- September 9, 2025
- Date of Event
- August 11, 2025
- Report Date
- September 9, 2025
- Manufacturer
- MOXIMED, INC.
- Product Code
- QVV
- UDI-DI
- 00856047005801
- PMA / PMN Number
- DEN220033
- Removal / Correction Number
- 3008274656/12022024/R/00
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- VA, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
THE FRACTURE AT THE TIBIAL END OF THE ABSORBER WAS CONFIRMED UPON REMOVAL OF THE DEVICE. THE ROOT CAUSE IS A SUPPLIER ERROR. AN INCORRECT DRILL WAS USED RESULTING IN AN INACCURATE DRILL POINT ANGLE AND REDUCED MATERIAL THICKNESS. THIS MIGHT INCREASE THE RISK OF IMPLANT FRACTURE IN ONE LOT WHERE THE SUPPLIER ERROR OCCURRED.
Description of Event or Problem · 0
PATIENT REPORTED MEDIAL KNEE PAIN. FRACTURE AT THE TIBIAL END OF THE ABSORBER WAS OBSERVED ON X-RAY. THE DEVICE WAS REMOVED WITHOUT DIFFICULTY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2869674 | MISHA KNEE SYSTEM | MEDIAL KNEE IMPLANTED SHOCK ABSORBER, PRODUCT CODE: QVV | QVV | MOXIMED, INC. | 23092503 | 00856047005801 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 43 YR | Male |