UNKNOWN DEPUY PATELLA UNK-KNEE

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,08 report with the FDA on 2014-09-30 for UNKNOWN DEPUY PATELLA UNK-KNEE manufactured by Depuy Orthopaedics, Inc..

Event Text Entries

[4793879] Patient was revised to address osteolysis and poly wear.
Patient Sequence No: 1, Text Type: D, B5


[12167536] (b)(4). Depuy synthes has been informed that the catalog number and lot number is not available. This complaint is still under investigation. Depuy will notify the fda of the results of this investigation once it has been completed. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[21219682] The device associated with this report was not returned. Requests for additional investigational inputs were made in accordance with wi-7915 appendix a. No additional information was obtained. Review of the device history records and/or a lot specific complaint database search was not possible as the product and lot code required was not provided. The investigation could not verify or identify any product contribution to the reported event with the information provided. Based on the inability to identify root cause, the need for corrective action was not indicated. Depuy considers the investigation closed at this time. Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1818910-2014-29100
MDR Report Key4129591
Report Source05,08
Date Received2014-09-30
Date of Report2014-09-22
Date of Event2014-09-22
Date Mfgr Received2014-11-24
Date Added to Maude2014-09-30
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactSTEVE DOWELL
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 46581
Manufacturer CountryUS
Manufacturer Postal46581
Manufacturer Phone5743714918
Manufacturer G1DEPUY ORTHOPAEDICS, INC.
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal Code46582
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNKNOWN DEPUY PATELLA
Generic NameKNEE PATELLAR COMPONENT
Product CodeHTG
Date Received2014-09-30
Catalog NumberUNK-KNEE
Lot NumberUNKNOWN
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDEPUY ORTHOPAEDICS, INC.
Manufacturer Address700 ORTHOPAEDIC DRIVE WARSAW IN 46582 US 46582


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2014-09-30

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