FDA Adverse Event Malfunction Summary report: N

MODULAR EBS KNEE JOINT

MDR report key: 9817134 · Received March 11, 2020

Report

Report Number
9616494-2018-00055
Event Type
Malfunction
Date Received
March 11, 2020
Date of Event
January 8, 2018
Report Date
February 20, 2018
Manufacturer
OTTO BOCK HEALTHCARE GMBH
Product Code
ISY
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE VISUAL EVALUATION SHOWED THAT TWO OF THE UPPER BOLTS WERE LOOSE. THE PATIENT FELL BUT THERE WERE NO SERIOUS INJURIES SUSTAINED AS A RESULT OF THE FALL. NO MEDICAL TREATMENT WAS NEEDED.

Description of Event or Problem · 1

KNEE JOINT WAS SENT IN FOR REPAIR. ACCORDING TO INFORMATION PROVIDED BY THE CUSTOMER THE BOLTS WERE LOOSE. PATIENT FELL, BUT THERE WERE NO SERIOUS INJURIES SUSTAINED AS A RESULT OF THE FALL. NO MEDICAL TREATMENT WAS NEEDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
280349 MODULAR EBS KNEE JOINT MODULAR EBS KNEE JOINT ISY OTTO BOCK HEALTHCARE GMBH 3R60

Patients

Seq Age Sex Outcome Treatment
1