MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,08 report with the FDA on 2013-02-25 for PFC C/R FEM POR LFT SZ5 864108 manufactured by 1818910 Depuy Orthopaedics, Inc..
[10719935]
The device associated with this report was not returned. Review of the device history records and/or a lot specific complaint database search was not possible as the lot code required was not provided. The initial reporting states that no further event information is available. The investigation could not draw any conclusions regarding the reported event with the information available. Based on the inability to determine a root cause, the need for corrective action was not indicated. Depuy considers the investigation closed at this time. Should the product and/or additional information be received, the investigation will be re-opened.
Patient Sequence No: 1, Text Type: N, H10
[17604093]
Patient was revised to address loosening of the non-cemented femoral component and loosening of the tibial tray at the cement/bone interface; however, the manufacturer of the cement used at the time of original implantation is unknown. It was noted that the patient had previously been revised because of a periprosthetic tibia fracture, but no information was available about that revision.
Patient Sequence No: 1, Text Type: D, B5
[17671590]
This complaint is still under investigation. Depuy will notify the fda of the results of this investigation once it has been completed.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1818910-2013-12758 |
| MDR Report Key | 2976241 |
| Report Source | 05,08 |
| Date Received | 2013-02-25 |
| Date of Report | 2013-02-11 |
| Date of Event | 2013-02-11 |
| Date Mfgr Received | 2013-02-11 |
| Date Added to Maude | 2013-02-25 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | STACEY TRICK |
| Manufacturer Street | 700 ORTHOPAEDIC DRIVE |
| Manufacturer City | WARSAW IN 46581 |
| Manufacturer Country | US |
| Manufacturer Postal | 46581 |
| Manufacturer Phone | 5743714554 |
| Manufacturer G1 | 1818910 DEPUY ORTHOPAEDICS, INC. |
| Manufacturer Street | 700 ORTHOPAEDIC DR. |
| Manufacturer City | WARSAW IN 46581 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 46581 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | PFC C/R FEM POR LFT SZ5 |
| Generic Name | FEMORAL KNEE PROSTHESIS |
| Product Code | HSA |
| Date Received | 2013-02-25 |
| Catalog Number | 864108 |
| Lot Number | UNKNOWN |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | 1818910 DEPUY ORTHOPAEDICS, INC. |
| Manufacturer Address | 700 ORTHOPAEDIC DR. WARSAW IN 46581 US 46581 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2013-02-25 |