FDA Adverse Event Injury Summary report: N

ATTUNE CR FEM RT SZ 4 CEM

MDR report key: 9268503 · Received November 1, 2019

Report

Report Number
1818910-2019-113727
Event Type
Injury
Date Received
November 1, 2019
Date of Event
August 28, 2018
Report Date
October 8, 2019
Manufacturer
DEPUY IRELAND - 9616671
Product Code
JWH
UDI-DI
10603295041191
PMA / PMN Number
K101433
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # (B)(4). THIS IS A DUPLICATE REPORT OF 1818910-2018-70134. 1818910-2019-113727 IS BEING RETRACTED AS IT IS A REPORT DUPLICATION. 1818910-2018-70134 WILL BE KEPT FOR INVESTIGATIONAL PURPOSES.

Additional Manufacturer Narrative · 1

(B)(4) INITIAL REPORTER OCCUPATION: LAWYER. 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

MEDICAL RECORDS RECEIVED AD 17 JUNE 2019. ON (B)(6) 2014, THE PATIENT UNDERWENT A RIGHT KNEE MANIPULATION UNDER ANESTHESIA DUE TO PAIN, DISCOMFORT, STIFFNESS, SWELLING, AND ARTHROFIBROSIS. NO PRODUCTS WERE REVISED DURING THE PROCEDURE. ON (B)(6) 2018, THE PATIENT UNDERWENT A RIGHT KNEE REVISION DUE TO STIFFNESS AND TIBIAL TRAY LOOSENING AT THE CEMENT TO IMPLANT INTERFACE. THE PATELLA WAS NOT REVISED. COMPETITOR CEMENT WAS USED DURING THE PRIMARY OPERATION. DOI: (B)(6) 2014; DOE: (B)(6) 2014; DOR: (B)(6) 2018; RIGHT KNEE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1061387 ATTUNE CR FEM RT SZ 4 CEM ATTUNE IMPLANT : KNEE FEMORAL JWH DEPUY IRELAND - 9616671 390031 10603295041191

Patients

Seq Age Sex Outcome Treatment
1 65 YR Required Intervention ATTUNE MEDIAL DOME PAT 32MM| COMPETITOR BONE CEMENT| COMPETITOR BONE CEMENT