MAUDE MDR 201455

MDR report key
201455
Report number
1043534-1998-00111
Event key
0
Event type
3
Date of event
1998-11-02
Date received
1998-12-09
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ADVANTIM POSTERIOR STABILIZED FEMORAL STEMKNEE COMPONENTWRIGHT MEDICAL TECHNOLOGY, INC.KRPNA1890-0038M659160YYY

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
11998-12-0901. R

Event Narratives#

D

Patient 1

REVISION SURGERY -- FRACTURED POST. ALLEGEDLY KNEE WAS NOT STABLE AND REQUIRED REVISION SURGERY.