FDA Adverse Event
Injury
Summary report: N
ITOTAL G2
MDR report key: 4925749
·
Received July 16, 2015
Report
- Report Number
- 3004153240-2015-00134
- Event Type
- Injury
- Date Received
- July 16, 2015
- Date of Event
- June 1, 2015
- Report Date
- June 25, 2015
- Manufacturer
- CONFORMIS
- Product Code
- OIY
- PMA / PMN Number
- K142161
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NE, US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
PATIENT DEVELOPED AN INFECTION. REVISION SURGERY WAS SCHEDULED TO EXCHANGE THE POLY INSERTS. REVIEW OF THE DEVICE HISTORY RECORD INDICATES THAT THE DEVICE WAS MANUFACTURED TO SPEC. ALL STERILIZATION REQUIREMENTS WERE MET.
Description of Event or Problem · 1
PATIENT DEVELOPED AN INFECTION. REVISION SURGERY WAS SCHEDULED TO EXCHANGE THE POLY INSERTS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 463772 | ITOTAL G2 | TOTAL KNEE REPLACEMENT SYSTEM | OIY | CONFORMIS |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 74 YR | Required Intervention |