MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-03-13 for GII FEMORAL IMPACTOR 71440190 manufactured by Smith & Nephew, Inc..
[183320998]
It was reported that when using the genesis knee impactor and making the impact, the device gave off a black material like dust which was quite difficult to remove even when it was washed with a pulsatile wash gun but they remained black in the bone and tissue which had to be removed with tweezers without ensuring that there is no residue left in the patient. No patient health information or statement has been received.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1020279-2020-00870 |
| MDR Report Key | 9830808 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2020-03-13 |
| Date of Report | 2020-03-13 |
| Date of Event | 2020-02-25 |
| Date Mfgr Received | 2020-03-03 |
| Date Added to Maude | 2020-03-13 |
| 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 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | DR. SARAH FREESTONE |
| Manufacturer Street | 1450 BROOKS ROAD |
| Manufacturer City | MEMPHIS TN 38116 |
| Manufacturer Country | US |
| Manufacturer Postal | 38116 |
| Manufacturer Phone | 0447940038 |
| Manufacturer G1 | SMITH & NEPHEW, INC. |
| Manufacturer Street | 1450 BROOKS ROAD |
| Manufacturer City | MEMPHIS TN 38116 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 38116 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | GII FEMORAL IMPACTOR |
| Generic Name | PROSTHESIS, HIP, FEMORAL COMPONENT, CEMENTED, METAL |
| Product Code | JDG |
| Date Received | 2020-03-13 |
| Model Number | 71440190 |
| Catalog Number | 71440190 |
| Lot Number | UNKNOWN/UNREADABLE |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | * |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SMITH & NEPHEW, INC. |
| Manufacturer Address | 1450 BROOKS ROAD MEMPHIS TN 38116 US 38116 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-03-13 |