FDA Adverse Event Injury Summary report: N

VANTAGE ANKLE COMPONENTS

MDR report key: 23302717 · Received October 15, 2025

Report

Report Number
1038671-2025-03118
Event Type
Injury
Date Received
October 15, 2025
Date of Event
July 16, 2024
Report Date
October 15, 2025
Manufacturer
EXACTECH, INC.
Product Code
HSN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

D10: 350-11-03 - TIBIAL PLATE FB SZ 3 LT: (B)(6). 350-21-12 - TIBIAL INSERT FB SZ 2 LT 7MM: (B)(6). 350-01-02 - TALAR IMPLANT SZ 2 LT: (B)(6). 350-10-03 - ANKLE SZ 3 LOCKING CLIP: (B)(6). THE REPORTED EVENT WAS UNABLE TO BE CONFIRMED DUE TO LIMITED INFORMATION RECEIVED FROM THE CUSTOMER. NO DEVICE WAS RETURNED FOR EVALUATION; FURTHER, PHOTOGRAPHS AND/OR RADIOGRAPH IMAGES WERE NOT PROVIDED FOR REVIEW. OPERATIVE NOTES AND/OR MEDICAL RECORDS WERE NOT PROVIDED FOR REVIEW OF USAGE/TECHNIQUE. A DEFINITIVE ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED. IF ANY FURTHER INFORMATION IS OBTAINED THAT WOULD CHANGE OR ALTER ANY INFORMATION PROVIDED, A SUPPLEMENTAL REPORT WILL BE FILED ACCORDINGLY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT AN INITIAL TOTAL ANKLE REPLACEMENT ON THE LEFT SIDE. IT WAS NOTED AT A FOLLOW UP THAT THE PATIENT FORMED A CYST. THEY THEN ROLLED THEIR ANKLE APPROXIMATELY 4 YEARS POST OPERATION WHICH STARTED TO CAUSED PAIN. THE PATIENT WAS REVISED, AND THE OUTCOME IS CONSIDERED RESOLVED. NO FURTHER INFORMATION AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2020512 VANTAGE ANKLE COMPONENTS PROSTHESIS, ANKLE, SEMI-CONSTRAINED, CEMENTED, METAL/POLYMER HSN EXACTECH, INC.

Patients

Seq Age Sex Outcome Treatment
1 NA Female Hospitalization SEE H11.