ATTUNE TIBIAL TRIAL EXTRACTOR 2545-00-138 254500138

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 2020-03-26 for ATTUNE TIBIAL TRIAL EXTRACTOR 2545-00-138 254500138 manufactured by Depuy Ireland - 9616671.

Event Text Entries

[185104920] Product complaint #: (b)(4). If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[185104921] It was reported that the articulating surface, shim and trial extractor were all broken or damaged while trying to remove the trial spacer. All pieces were retrieved from the patient.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1818910-2020-09361
MDR Report Key9884580
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-26
Date of Report2020-03-13
Date of Event2020-03-13
Date Mfgr Received2020-04-01
Device Manufacturer Date2014-09-19
Date Added to Maude2020-03-26
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 ContactMS. KARA DITTY-BOVARD
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 465810988
Manufacturer CountryUS
Manufacturer Postal465810988
Manufacturer Phone6107428552
Manufacturer G1DEPUY ORTHOPAEDICS, INC. 1818910
Manufacturer Street700 ORTHOPAEDIC DRIVE
Manufacturer CityWARSAW IN 465820988
Manufacturer CountryUS
Manufacturer Postal Code465820988
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameATTUNE TIBIAL TRIAL EXTRACTOR
Generic NameATTUNE INSTRUMENTS : EXTRACTION INSTRUMENTS
Product CodeHWB
Date Received2020-03-26
Returned To Mfg2020-03-18
Model Number2545-00-138
Catalog Number254500138
Lot NumberBFA0WLY
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerDEPUY IRELAND - 9616671
Manufacturer AddressLOUGHBEG RINGASKIDDY CO. CORK EI


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-26

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