MAUDE Adverse Event Report: CONFORMIS, INC. IDUO G2; BICOMPARTMENTAL KNEE REPLACEMENT SYSTEM

Catalog Number M5723INT0600220

Device Problem Loosening of Implant Not Related to Bone-Ingrowth (4002)

Patient Problem Fall (1848)

Event Date 06/01/2020

Event Type  Injury  

Manufacturer Narrative

It was reported that the patient fell and now has loosening of their poly insert.Revision surgery is planned to exchange the poly insert.Review of the device history record indicates that the device was manufactured to specification.

Event Description

It was reported that the patient fell and now has loosening of their poly insert.Revision surgery is planned to exchange the poly insert.

• Brand Name: IDUO G2
• Type of Device: BICOMPARTMENTAL KNEE REPLACEMENT SYSTEM
• Manufacturer (Section D): CONFORMIS, INC.; 600 technology park drive; billerica, ma
• Manufacturer (Section G): CONFORMIS, INC.; 600 research drive; wilmington, ma
• Manufacturer Contact: emmanuel nyakako ; 600 technology park drive; billerica, ma ; 3459164
• MDR Report Key: 10215463
• MDR Text Key: 197087253
• Report Number: 3004153240-2020-00116
• Device Sequence Number: 1
• Product Code: NPJ
• Combination Product (y/n): N
• Reporter Country Code: GM
• PMA/PMN Number: K133256
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: foreign,health professional
• Reporter Occupation: Physician
• Type of Report: Initial
• Report Date: 06/30/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Device Catalogue Number: M5723INT0600220
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 06/10/2020
• Initial Date FDA Received: 06/30/2020
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 11/18/2015
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention
• Patient Age: 46 YR