CEMENT

Report

• Report Number: MW5179444
• Event Type: Injury
• Date Received: November 28, 2025
• Date of Event: January 1, 2025
• Report Date: November 21, 2025
• Manufacturer: HERAEUS MEDICAL LLC.
• Product Code: KIH
• Adverse Event: Yes
• Report Source: Voluntary report
• Reporter Occupation: UNKNOWN
• Health Professional: *

Narratives

Description of Event or Problem · 0

SUBJECT ID: (B)(6). STUDY NO: (B)(4). CLINICAL ADVERSE EVENT RECEIVED FOR ANTERIOR KNEE PAIN. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).

Devices

Seq	Brand	Generic	Product Code	Manufacturer	Model	Lot	UDI-DI
2156212	CEMENT	DISPENSER, CEMENT	KIH	HERAEUS MEDICAL LLC.

Patients

Seq	Age	Sex	Outcome	Treatment
1	NA	Unknown

Terms

Patient problem · 1

• Pain

Product problems · 1

• Adverse Event Without Identified Device or Use Problem

Type of report · 1

• Initial submission