ATTUNE PS RP INSRT SZ 5 10MM 1516-50-510 151650510

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-03-25 for ATTUNE PS RP INSRT SZ 5 10MM 1516-50-510 151650510 manufactured by Depuy Ireland - 9616671.

Event Text Entries

[186303764] (b)(4). If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate. Investigation summary: no device associated with this report was received for examination. A worldwide complaint database search found no other related reported incidents against the provided product code/lot number combination since release for distribution. Based on previous investigations, this complication of joint replacement is unlikely to have been the result of a device failing to meet required specifications. The information received will be retained for potential series investigations if triggered by trend analysis, post market surveillance, or other events within the quality system.
Patient Sequence No: 1, Text Type: N, H10


[186303765] Clinical adverse event received for significant left patellar crepitus. Event is not serious and is considered moderate. Event is possibly related to device and definitely related to procedure. Date of implantation: (b)(6) 2018, date of event (onset): (b)(6) 2019, (left knee).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1818910-2020-09217
MDR Report Key9879003
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-25
Date of Report2019-11-15
Date of Event2019-08-21
Date Mfgr Received2020-03-09
Device Manufacturer Date2017-03-19
Date Added to Maude2020-03-25
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactKARA DITTY-BOVARD
Manufacturer Street700 ORTHOPAEDIC DR.
Manufacturer CityWARSAW IN 465810988
Manufacturer CountryUS
Manufacturer Postal465810988
Manufacturer Phone6107428552
Manufacturer G1DEPUY IRELAND - 9616671
Manufacturer StreetLOUGHBEG RINGASKIDDY CO.
Manufacturer CityCORK
Manufacturer CountryEI
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameATTUNE PS RP INSRT SZ 5 10MM
Generic NameATTUNE IMPLANT : KNEE TIBIAL INSERT
Product CodeNJL
Date Received2020-03-25
Model Number1516-50-510
Catalog Number151650510
Lot Number8491845
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDEPUY IRELAND - 9616671
Manufacturer AddressLOUGHBEG RINGASKIDDY CO. CORK EI


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-03-25

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