FDA Adverse Event Injury Summary report: N

OPTETRAK TIBIAL TRAY, FINNED, CEMENTED

MDR report key: 4973341 · Received August 5, 2015

Report

Report Number
1038671-2015-00411
Event Type
Injury
Date Received
August 5, 2015
Date of Event
September 17, 2014
Report Date
August 5, 2015
Manufacturer
EXACTECH, INC
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE CONTRIBUTION OF THE DEVICES TO THE EXPERIENCE REPORTED COULD NOT BE DETERMINED AS THE DEVICES WERE NOT RETURNED FOR EVALUATION. ADDITIONALLY, THE DEVICE SPECIFIC INFORMATION WAS NOT PROVIDED, PRECLUDING A REVIEW OF THE DEVICE HISTORY RECORD.

Description of Event or Problem · 1

INDEX SURGERY: (B)(6) 2014. REVISION OF RIGHT KNEE COMPONENTS DUE TO INFECTION AND INFLAMMATORY REACTION OF PROSTHETIC DEVICES. A SPACER WAS LEFT IN. THIS EVENT REPORT WAS RECEIVED THROUGH CLINICAL DATA COLLECTION ACTIVITIES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
514029 OPTETRAK TIBIAL TRAY, FINNED, CEMENTED TIBIAL TRAY JWH EXACTECH, INC

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization