MAUDE MDR 136785

MDR report key
136785
Report number
1043534-1997-00194
Event key
0
Event type
3
Date of event
1995-09-01
Date received
1997-12-03
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1DURAMER ADVANTIM POROUS METAL-BACK PATELLAKNEE COMPONENTWRIGHT MEDICAL TECHNOLOGY, INC.KRPNA1880-0432093M902630YNN

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
11997-12-0301. R

Event Narratives#

D

Patient 1

PER STERILIZATION STUDY REVISION SURGERY WAS PERFORMED DUE TO ALLEGED FRACTURE OF PATELLA BONE.