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 |