FDA Adverse Event Injury Summary report: N

UNKNOWN TALAR COMPONTENT

MDR report key: 4251341 · Received November 14, 2014

Report

Report Number
1818910-2014-31744
Event Type
Injury
Date Received
November 14, 2014
Date of Event
October 15, 2014
Report Date
October 15, 2014
Manufacturer
DEPUY ORTHOPAEDICS, INC.
Product Code
HSN
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
PHYSICIAN

Narratives

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. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE. FOLLOW-UP WITH THE COMPLAINANT HAS BEEN CONDUCTED FOR THE CATALOG AND LOT NUMBER AND THIS INFORMATION IS NOT AVAILABLE.

Additional Manufacturer Narrative · 1

THE DEVICE ASSOCIATED WITH THIS REPORT WAS NOT RETURNED. REQUESTS FOR ADDITIONAL INVESTIGATIONAL INPUTS WERE MADE IN ACCORDANCE WITH WI-7915 APPENDIX A. ONE PATIENT X-RAY WAS PROVIDED FOR REVIEW. REVIEW OF THE X-RAY REVEALED EVIDENCE SUGGESTING POLYETHYLENE WEAR. IT WAS NOT POSSIBLE TO DETERMINE IF THERE IS SUBSIDENCE OF THE TIBIAL COMPONENT ON THE X-RAY VIEW PROVIDED. REVIEW OF THE DEVICE HISTORY RECORDS AND/OR A LOT SPECIFIC COMPLAINT DATABASE SEARCH WAS NOT POSSIBLE AS THE PRODUCT AND/OR LOT CODE REQUIRED WAS NOT PROVIDED. THE INVESTIGATION COULD NOT VERIFY OR IDENTIFY ANY PRODUCT CONTRIBUTION TO THE REPORTED EVENT WITH THE INFORMATION PROVIDED. BASED ON THE INABILITY TO IDENTIFY ROOT CAUSE, THE NEED FOR CORRECTIVE ACTION WAS NOT INDICATED. DEPUY CONSIDERS THE INVESTIGATION CLOSED AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE RECEIVED, THE INFORMATION WILL BE REVIEWED AND THE INVESTIGATION WILL BE RE-OPENED AS NECESSARY.

Description of Event or Problem · 1

PATIENT WAS REVISED TO ADDRESS SUBSIDENCE AND POLYWEAR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
737795 UNKNOWN TALAR COMPONTENT ANKLE IMPLANT HSN DEPUY ORTHOPAEDICS, INC. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 56 YR Required Intervention