FDA Adverse Event Malfunction Summary report: N

LCS 7IN 9MM ROD

MDR report key: 7645094 · Received June 28, 2018

Report

Report Number
1818910-2018-63365
Event Type
Malfunction
Date Received
June 28, 2018
Date of Event
June 6, 2018
Report Date
June 6, 2018
Manufacturer
DEPUY ORTHOPAEDICS, INC. 1818910 
Product Code
HWT
UDI-DI
10603295110033
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4) EXAMINATION OF THE RETURNED DEVICE CONFIRMED THE REPORTED EVENT. 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. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH , A FOLLOW-UP MEDWATCH, WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

(B)(4). IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

TKA SURGERY WAS PERFORMED ON (B)(6) 2018. DURING THE SURGERY, THE SURGEON INSTALLED AP CUTTING GUIDE MED AFTER SIZE MEASUREMENT TO THE PATIENT¿S KNEE JOINT, AND DRILLING WAS PERFORMED NORMALLY USING THE IM INITIATOR DRILL FOR THE TIBIA. THEN, WHEN THE SURGEON TRIED TO MOUNT THE ROD TO THE GUIDE, IT WAS REPORTED THAT FEMORAL IM ALIGNMENT ROD COULD NOT BE MOUNTED TO THE CUTTING GUIDE BECAUSE THE HOLES COULD NOT FIT. THE SURGERY WAS COMPLETED BY HAMMERING THE ALIGNMENT ROD INTO THE CUTTING GUIDE WITH A HAMMER. AFTER SURGERY, THE SURGEON CHECKED THE INSTRUMENT¿S CONDITION, AND FOUND THAT IT WAS DIFFICULT TO DETACH IT BY HAND. THERE WAS LESS THAN 30 MIN. SURGICAL DELAY AND THERE WAS NO ADVERSE CONSEQUENCE TO THE PATIENT. NO FURTHER INFORMATION WAS PROVIDED BY THE HOSPITAL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
487048 LCS 7IN 9MM ROD KNEE INSTRUMENT : ALIGNMENT DEVICES HWT DEPUY ORTHOPAEDICS, INC. 1818910  10603295110033

Patients

Seq Age Sex Outcome Treatment
1