FDA Adverse Event Injury Summary report: N

GMK FIXED CEMENTED TIBIAL TRAY SIZE 2 RIGHT

MDR report key: 3519926 · Received November 22, 2013

Report

Report Number
3005180920-2013-00147
Event Type
Injury
Date Received
November 22, 2013
Manufacturer
MEDACTA INTERNATIONAL, SA
Product Code
JWH
PMA / PMN Number
K090988
Report Source
Manufacturer report

Narratives

Additional Manufacturer Narrative · 1

DOCUMENT REVIEW: GMK FIXED CEMENTED TIBIAL TRAY SIZE 2 RIGHT. CODE (B)(4) / LOT 113398 (30 ITEMS PRODUCED): ALL PARAMETERS WERE FOUND TO BE IN ACCORDANCE WITH THE SPECIFICATIONS VALID AT THE TIME OF MANUFACTURING. TWENTY-FIVE ITEMS BELONGING TO THIS LOT HAVE BEEN ALREADY SOLD AND NO SIMILAR INCIDENTS HAVE BEEN REPORTED. ON THE BASIS OF THE DATA COLLECTED, WE HAVE NO EVIDENCES THAT THE PROBLEM IS DEVICE RELATED.

Description of Event or Problem · 1

REFERENCE IMPORTER REPORT # (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
609402 GMK FIXED CEMENTED TIBIAL TRAY SIZE 2 RIGHT FIXED TIBIAL BASE PLATE JWH MEDACTA INTERNATIONAL, SA

Patients

Seq Age Sex Outcome Treatment
1