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