MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1994-05-02 for TOTAL KNEE 6638-1-790 manufactured by Howmedica, Inc..
[20523721]
Pt complained of pain in right knee - x-rays showed tibial component was in slight vaarus position. Device labeled for single use. Patient medical status prior to event: unknown. 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. Device used as labeled/intended. Device was evaluated after the event. Method of evaluation: none or unknown. Results of evaluation: none or unknown. Conclusion: none or unknown. Certainty of device as cause of or contributor to event: yes. Corrective actions: none or unknown. Invalid data - on device destroyed/disposed of status.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 33274-1994-00014 |
| MDR Report Key | 8091 |
| Date Received | 1994-05-02 |
| Date of Report | 1994-04-20 |
| Date of Event | 1994-04-15 |
| Date Facility Aware | 1994-04-18 |
| Report Date | 1994-04-20 |
| Date Reported to FDA | 1994-04-20 |
| Date Reported to Mfgr | 1994-04-20 |
| Date Added to Maude | 1994-06-22 |
| Event Key | 0 |
| Report Source Code | Distributor report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Reporter Occupation | UNKNOWN |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TOTAL KNEE |
| Generic Name | PCA TOTAL KNEE SM BASEPLATE |
| Product Code | EEA |
| Date Received | 1994-05-02 |
| Catalog Number | 6638-1-790 |
| Lot Number | HCKVB |
| Operator | OTHER HEALTH CARE PROFESSIONAL |
| Device Availability | * |
| Implant Flag | Y |
| Device Sequence No | 1 |
| Device Event Key | 7766 |
| Manufacturer | HOWMEDICA, INC. |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 1994-05-02 |