FDA Adverse Event Injury Summary report: N

MCK TIBIAL ONLAY INSERT- SZ 5- 8MM

MDR report key: 4913348 · Received July 14, 2015

Report

Report Number
3005985723-2015-00122
Event Type
Injury
Date Received
July 14, 2015
Date of Event
June 19, 2015
Report Date
June 19, 2015
Manufacturer
MAKO SURGICAL CORP.
Product Code
NPJ
PMA / PMN Number
K090763
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

AN EVALUATION OF THE DEVICE CANNOT BE PERFORMED AS THE DEVICE WAS NOT RETURNED TO THE MANUFACTURER. ADDITIONAL INFORMATION HAS BEEN REQUESTED, BUT NOT MADE AVAILABLE. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE IT WILL BE REPORTED IN A SUPPLEMENTAL REPORT UPON COMPLETION OF THE INVESTIGATION. NOT RETURNED TO THE MANUFACTURER.

Description of Event or Problem · 1

THE PATIENT GOT AN INFECTION IN THE OPERATIVE LEG AND DR REPLACED THE POLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
454973 MCK TIBIAL ONLAY INSERT- SZ 5- 8MM IMPLANT NPJ MAKO SURGICAL CORP. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 75 YR Required Intervention