MAUDE MDR 7732

MDR report key
7732
Report number
7732
Event key
0
Event type
3
Date received
1994-04-26
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
0
Initial report to FDA
0
Event location
3

Manufacturer Contact#

Report source
U
Manufacturer link flag
N

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ROBERT BRIGHAM UNI-CONDYLAR KNEE - REINFORCED TIBIAL PLATEAUJOHNSON & JOHNSON PRODUCTS, INC. - ORTHOPAEDICS DIV.KMB86-6442 8.OMM TIB./86-5400 FEM059X - TIB./8579 - FEMOR.YY

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
11994-04-2601. O

Event Narratives#

D

Patient 1

THE UNI-CONDYLAR KNEE COMPONENTS WERE NOTED TO BE SIGNIFICANTLY DAMAGED WITH THE POLYETHYENE QUITE FRAGMENTED AND THE BASEPLATE OF THE TIBIAL COMPONENT EXPOSED UPON EXPLANTATION. THERE WAS WEAR ON THE FEMORAL COMPONENT. PIECES OF POLYETHYLENE WAS FOUND THROUGHOUT THE JOINT.DEVICE LABELED FOR SINGLE USE. PATIENT MEDICAL STATUS PRIOR TO EVENT: SATISFACTORY CONDITION. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY.NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. INVALID DATA - WHETHER DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: ACTUAL DEVICE INVOLVED IN INCIDENT WAS EVALUATED, VISUAL EXAMINATION. RESULTS OF EVALUATION: COMPONENT FAILURE. CONCLUSION: DEVICE FAILURE DIRECTLY CAUSED EVENT. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: YES. CORRECTIVE ACTIONS: DEVICE PERMANENTLY REMOVED FROM SERVICE. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.