FDA Adverse Event Malfunction Summary report: N

ATTUNE PS FB INSRT SZ 8 5MM

MDR report key: 9521074 · Received December 26, 2019

Report

Report Number
1818910-2019-124715
Event Type
Malfunction
Date Received
December 26, 2019
Date of Event
October 2, 2019
Report Date
October 2, 2019
Manufacturer
DEPUY IRELAND - 9616671
Product Code
JWH
UDI-DI
10603295050346
PMA / PMN Number
K111433
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CI
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # (B)(4). INVESTIGATION SUMMARY: THE RECEIVED DEVICE WAS FORWARDED TO COMMERCIALIZED PRODUCT DEVELOPMENT FOR EVALUATION. REVIEW OF THE RECEIVED DEVICE IDENTIFIED POLYWEAR. 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. (B)(4). 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

ON WEDNESDAY, (B)(6) 2019 AT 10:00 A.M. DR. (B)(6) HOSPITAL TRAUMATOLOGIST, PERFORMS ATTUNE KNEE PROSTHESIS REVIEW SURGERY TO THE GMG PATIENT, BECAUSE THE PATIENT HAD BEEN SUFFERING PAIN IN HIS LEFT KNEE FOR MONTHS, OPERATED WITH A PRIMARY PROSTHESIS ON (B)(6) 2016 IN THE SAME HOSPITAL. AT THE TIME OF THE REVISION SURGERY THE DOCTOR MAKES AN INCISION WHERE HE TAKES CULTURES, AND IT IS FOUND THAT THE PROBLEM IS PRESENTED BY THE PRIMARY TIBIAL PLATEAU THAT IS LOOSENED, WHICH LEAVES COMPLETELY WITHOUT CEMENT ATTACHED TO THE IMPLANT, THE AREA OF THE TIBIAL PLATEAU IS THE BONE WITH ALL THE INTER-DIGITED CEMENT MAKING ITS EXTRACTION DIFFICULT AND THE FEMORAL COMPONENT WAS COMPLETELY ADHERED TO THE BONE WITHOUT PROBLEMS. IN ADDITION, THE DOCTOR REQUESTS TO SEND THE POLYETHYLENE INSERT FOR STUDY. CURRENT PATIENT STATUS: HE IS HOSPITALIZED POST-OPERATED ATTUNE REVISION PROSTHESIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1314928 ATTUNE PS FB INSRT SZ 8 5MM ATTUNE IMPLANT : KNEE TIBIAL INSERT JWH DEPUY IRELAND - 9616671 603169 10603295050346

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention