VANTAGE ANKLE COMPONENTS
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
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.
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. |