DISCOVERY ELBOW 114823

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2020-01-13 for DISCOVERY ELBOW 114823 manufactured by Encore Medical L.p..

Event Text Entries

[174731205] Additional reporting on this event will be provided as a supplemental report to these document as soon as it becomes available.
Patient Sequence No: 1, Text Type: N, H10


[174731206] Revision surgery: all implants removed due to infection. Cement used as antibiotic spacer.
Patient Sequence No: 1, Text Type: D, B5


[186453212] The reason for this revision surgery was reported as an infection. The previous revision surgery and the revision surgery detailed in this event occurred 6. 5 months apart. The healthcare professional indicated there was no delay in surgery and another suitable device was available for use. The revision surgery was completed as intended. The devices were disposed of at hospital and not made available to djo surgical for examination. A review of the device history records (dhr) show that the reported components used in the previous surgery, when released for use, met design and manufacturing requirements. There were no non-conforming material reports (ncmr) associated with the products that may have contributed to the reported event. The devices were verified to have gone through an acceptable sterilization process and were within its expiration date at the time of the previous surgery. Customer complaint history of the reported devices showed no present trends or on-going issues that are needing a review. The root cause of this complaint was a revision surgery due to an infection. There were no findings during this evaluation that indicate the reported devices were the source or had a direct connection with the patient's infection. No information was submitted with the complaint regarding pre-existing conditions of the patient or any activities the patient was involved in that may have contributed to the infection or inhibited the patient's immune system. There are multiple factors that may contribute to an infection that are outside the control of djo surgical. There are no indications of a product or process issue affecting implant safety or effectiveness.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1644408-2019-01328
MDR Report Key9581588
Report SourceCOMPANY REPRESENTATIVE
Date Received2020-01-13
Date of Report2020-02-11
Date of Event2019-12-18
Date Mfgr Received2020-01-14
Device Manufacturer Date2017-09-21
Date Added to Maude2020-01-13
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 FDA3
Event Location3
Manufacturer ContactTEFFANY HUTTO
Manufacturer Street9800 METRIC BLVD
Manufacturer CityAUSTIN, TX 78758-5445,
Manufacturer CountryUS
Manufacturer G1ENCORE MEDICAL L.P.
Manufacturer Street9800 METRIC BLVD
Manufacturer CityAUSTIN, TX 78758-5445,
Manufacturer CountryUS
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDISCOVERY ELBOW
Generic NameDISC ULNA 4X75MM RT W BRNG C
Product CodeJDC
Date Received2020-01-13
Catalog Number114823
Lot Number930400
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerENCORE MEDICAL L.P.
Manufacturer Address9800 METRIC BLVD AUSTIN, TX 78758-5445, US


Patients

Patient NumberTreatmentOutcomeDate
11149071. Required No Informationntervention 2020-01-13

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