FDA Adverse Event Injury Summary report: N

LEGION CR NP FEM SZ 8 RT

MDR report key: 8348424 · Received February 18, 2019

Report

Report Number
1020279-2019-00646
Event Type
Injury
Date Received
February 18, 2019
Date of Event
October 25, 2016
Report Date
August 30, 2019
Manufacturer
SMITH & NEPHEW, INC.
Product Code
JWH
UDI-DI
00885556030165
PMA / PMN Number
K060742
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

THE ASSOCIATED COMPLAINT DEVICES WERE NOT RETURNED. A REVIEW OF THE MANUFACTURING RECORDS FOR THE LISTED BATCHES DID NOT REVEAL A MANUFACTURING ABNORMALITY THAT COULD HAVE CAUSED OR CONTRIBUTED TO THE REPORTED INCIDENT. A REVIEW OF COMPLAINT HISTORY DID NOT REVEAL ADDITIONAL COMPLAINTS FOR THE LISTED BATCHES. THE CLINICAL/ MEDICAL EVALUATION CONCLUDED THAT THE RESULTS FROM THE ARTHROCENTESIS REVEALED A CRP LEVEL OF 10.00MG/L. ALL OTHER LABS WHERE WITHIN NORMAL LIMITS. THERE WAS NO INDICATION OF ANY MEDICAL INTERVENTIONS PROVIDED TO ADDRESS THE ELEVATED CRP. C-0231325, C-0232561, C-0232564, C-0232613: THE X-RAYS PROVIDED TAKEN YEARS AFTER THE ELEVATED CRP PROVIDED HAD THE SUSPICION OF THE LOOSENING OF THE TIBIAL OR FEMORAL COMPONENTS OF RIGHT TKA. DETAILS REGARDING THE PATIENT¿S WEIGHT-BEARING STATUS, BONE QUALITY, FALL/TRAUMA HISTORY, AND OTHER ADDITIONAL CLINICAL RELEVANT INFORMATION HAVE NOT BEEN PROVIDED. BASED ON THE LIMITED INFORMATION PROVIDED AND WITHOUT THE RETURN OF THE DEVICE FOR EVALUATION THE ROOT CAUSE OF THE REPORTED PAIN CANNOT BE DETERMINED. HOWEVER, THE LOOSENING OF THE COMPONENTS COULD HAVE BEEN A CONTRIBUTING FACTOR TO THE REPORTED PAIN. C-0232078, C-0232617, C-0232619, C-0232620: ALTHOUGH A FLUOROSCOPICALLY GUIDED RIGHT TKA ASPIRATION WAS PERFORMED TWO MONTHS POST REVISION NO RESULT WERE PROVIDED FOR REVIEW. THEREFORE, WERE UNABLE TO CONFIRM AN INFECTION AS A CONTRIBUTORY FACTOR. THE PATIENT IMPACT BEYOND THE REPORTED PAIN CANNOT BE DETERMINED. NO FURTHER CLINICAL ASSESSMENT IS WARRANTED AT THIS TIME. WITHOUT THE ACTUAL PRODUCT INVOLVED, OUR INVESTIGATION CANNOT PROCEED. IF THE DEVICE OR NEW INFORMATION IS RECEIVED IN THE FUTURE, THESE COMPLAINTS CAN BE RE-OPENED. NO FURTHER ACTIONS ARE BEING TAKEN AT THIS TIME.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT HAD AN ARTHROCENTESIS OF RIGHT KNEE DUE TO CHRONIC PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
141083 LEGION CR NP FEM SZ 8 RT PROSTH, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONST, CEMENTED, POLY/METAL/POLY JWH SMITH & NEPHEW, INC. 13GM06370 00885556030165

Patients

Seq Age Sex Outcome Treatment
1 55 YR Hospitalization| R