FDA Adverse Event Injury Summary report: N

ATTUNE PS FB INSRT SZ 3 12MM

MDR report key: 3212373 · Received July 9, 2013

Report

Report Number
1818910-2013-20724
Event Type
Injury
Date Received
July 9, 2013
Date of Event
June 29, 2013
Report Date
June 29, 2013
Manufacturer
DEPUY-RAYNHAM, A DIV. OF DEPUY ORTHOPAEDICS
Product Code
JWH
PMA / PMN Number
PK111433
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE ASSOCIATED WITH THIS REPORT WAS NOT RETURNED. A COMPLAINT DATABASE SEARCH FINDS NO OTHER REPORTED INCIDENTS AGAINST THE PROVIDED PRODUCT AND LOT COMBINATION SINCE ITS RELEASE FOR DISTRIBUTION. REQUESTS FOR ADDITIONAL INVESTIGATIONAL INPUTS WERE MADE IN ACCORDANCE WITH WI-7915 APPENDIX A; REV. D. NO ADDITIONAL INFORMATION WAS OBTAINED. THE INVESTIGATION COULD NOT DRAW ANY CONCLUSIONS REGARDING THE REPORTED EVENT. BASED ON THE INABILITY TO DETERMINE A ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD THE PRODUCT AND/OR ADDITIONAL INFORMATION BE RECEIVED, THE INVESTIGATION WILL BE RE-OPENED.

Additional Manufacturer Narrative · 1

THIS COMPLAINT IS STILL UNDER INVESTIGATION. DEPUY WILL NOTIFY THE FDA OF THE RESULTS OF THIS INVESTIGATION ONCE IT HAS BEEN COMPLETED.

Description of Event or Problem · 1

PATIENT WAS REVISED TO ADDRESS INFECTION. IT WAS REPORTED THAT SHE WAS RIDING A BIKE IN PHYSICAL THERAPY 12 DAYS POST-OP, WHEN HER INCISION SPLIT OPEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
313291 ATTUNE PS FB INSRT SZ 3 12MM TIBIAL KNEE INSERT JWH DEPUY-RAYNHAM, A DIV. OF DEPUY ORTHOPAEDICS 355235

Patients

Seq Age Sex Outcome Treatment
1 66 YR Required Intervention