FDA Adverse Event
Injury
Summary report: N
ITOTAL G2
MDR report key: 3833370
·
Received May 16, 2014
Report
- Report Number
- 3004153240-2014-00058
- Event Type
- Injury
- Date Received
- May 16, 2014
- Date of Event
- April 1, 2014
- Report Date
- April 30, 2014
- Manufacturer
- CONFORMIS
- Product Code
- JWH
- PMA / PMN Number
- K120316
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
REVIEW OF THE DEVICE HISTORY RECORD INDICATES THAT THE DEVICE WAS MANUFACTURED TO SPECIFICATION.
Description of Event or Problem · 1
POTENTIAL INFECTION WAS REPORTED FOR PATIENT WITH BILATERAL TOTAL KNEE IMPLANTS. INCISION AND DRAINAGE PROCEDURE IS PLANNED. POLY INSERTS MAY BE EXCHANGED DURING THE PROCEDURE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 293336 | ITOTAL G2 | TOTAL KNEE REPLACEMENT SYSTEM | JWH | CONFORMIS |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 67 YR | Required Intervention |