FDA Adverse Event Malfunction Summary report: N

ATTUNE RP TIBIAL IMPACTOR

MDR report key: 7943648 · Received October 8, 2018

Report

Report Number
1818910-2018-71643
Event Type
Malfunction
Date Received
October 8, 2018
Date of Event
September 26, 2018
Report Date
September 26, 2018
Manufacturer
DEPUY IRELAND - 9616671
Product Code
HWA
UDI-DI
10603295130208
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NE, US
Reporter Occupation
PHYSICIAN

Narratives

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.

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # (B)(4). INVESTIGATION SUMMARY NO DEVICE ASSOCIATED WITH THIS REPORT WAS RECEIVED FOR EXAMINATION. 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.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE 2 RP IMPACTORS WERE BROKEN UPON IMPACTION OF THE TIBIAL BASE-PLATE WHILE CEMENTING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
785840 ATTUNE RP TIBIAL IMPACTOR ATTUNE INSTRUMENTS : IMPACTORS HWA DEPUY IRELAND - 9616671 AU3664789 10603295130208

Patients

Seq Age Sex Outcome Treatment
1 66 YR