FDA Adverse Event Injury Summary report: N

UNKNOWN KNEE IMPLANT

MDR report key: 8723640 · Received June 21, 2019

Report

Report Number
1020279-2019-02393
Event Type
Injury
Date Received
June 21, 2019
Date of Event
January 1, 1901
Report Date
October 10, 2019
Manufacturer
SMITH & NEPHEW, INC.
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THE ASSOCIATED COMPLAINT DEVICE WAS NOT RETURNED. THE CLINICAL/MEDICAL TEAM CONCLUDED THAT NO CLINICAL INFORMATION HAS BEEN PROVIDED TO PERFORM A THOROUGH MEDICAL INVESTIGATION. SHOULD ANY ADDITIONAL MEDICAL INFORMATION BE PROVIDED THIS COMPLAINT WILL BE RE-ASSESSED. WITHOUT THE ACTUAL PRODUCT INVOLVED OUR INVESTIGATION CANNOT PROCEED. NO FURTHER INVESTIGATION IS WARRANTED FOR THIS COMPLAINT; HOWEVER WE WILL CONTINUE TO MONITOR FOR FUTURE COMPLAINTS AND INVESTIGATE FURTHER AS NECESSARY. IF THE DEVICES ARE RECEIVED IN THE FUTURE, THIS COMPLAINT CAN BE RE-OPENED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING SURGERY, THE SURGEON CONVERTED TO CR DUE TO IT WAS NOT HAPPY WITH THE PATIENT'S LIGAMENT STABILITY. NO ADDITIONAL DETAILS WERE PROVIDED, AND NO MORE INFORMATION IS AVAILABLE AT THIS MOMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
518231 UNKNOWN KNEE IMPLANT PROSTHESIS,KNEE,PATELLOFEMOROTIBIAL,SEMI-CONSTRAINED,CEMENTED,POLY/METAL/POLY JWH SMITH & NEPHEW, INC. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention