FDA Adverse Event Injury Summary report: N

GMK-HINGE 02.09.0214H FIXED TIBIAL INSERT SIZE 2/14MM

MDR report key: 8319911 · Received February 8, 2019

Report

Report Number
3005180920-2019-00044
Event Type
Injury
Date Received
February 8, 2019
Date of Event
January 11, 2019
Report Date
February 8, 2019
Manufacturer
MEDACTA INTERNATIONAL SA
Product Code
KRO
UDI-DI
07630030825064
PMA / PMN Number
K130299
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 1

BATCH REVIEW PERFORMED ON 05 FEBRUARY 2019. LOT 181574: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 28 JUNE 2018. EXPIRATION DATE: 2023-06-11. NO ANOMALIES FOUND RELATED TO THE PROBLEM. TO DATE, (B)(4) ITEMS OF THE SAME LOT HAVE BEEN ALREADY SOLD WITHOUT ANY SIMILAR REPORTED EVENT.

Description of Event or Problem · 1

ABOUT 2 MONTHS AFTER PRIMARY THE SURGEON REVISED THE PATIENT KNEE FOR INFECTION. I&D AND INSERT SWAP PERFORMED SUCCESSFULLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
113756 GMK-HINGE 02.09.0214H FIXED TIBIAL INSERT SIZE 2/14MM KNEE TIBIAL INSERT KRO MEDACTA INTERNATIONAL SA 181574 07630030825064

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention