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