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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AESCULAP AG AS VEGA PS FEMORAL COMP.CEMENTED F6N L; KNEE ENDOPROSTHETICS

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AESCULAP AG AS VEGA PS FEMORAL COMP.CEMENTED F6N L; KNEE ENDOPROSTHETICS Back to Search Results
Model Number NX013Z
Device Problem Loosening of Implant Not Related to Bone-Ingrowth (4002)
Patient Problems Pain (1994); Synovitis (2094); Ambulation Difficulties (2544); Swelling/ Edema (4577)
Event Type  Injury  
Manufacturer Narrative
Reference code nx013z, device name as vega ps femoral comp.Cemented f6n l, serial number n/a, batch number 51884096, udi device identifier (b)(4), udi production identifier (b)(4), basic udi-di n/a, unit of use udi-di (b)(4), manufacturing date 2012-09-28.Reference code nx055z, device name as vega ps tibial plateau cemented t3, serial number n/a, batch number 51867615, udi device identifier (b)(4), udi production identifier (b)(4), basic udi-di n/a, unit of use udi-di (b)(4), manufacturing date 2012-07-18.Ref.Code device name batch, nx043 patella 3-pegs p3 51896704, nx131 vega ps gliding surface t3/3+ 12mm 51904696, nn260p plug f/tibial plateau 51904876.Investigation: no product at hand.Therefore an investigation at the device is not possible.Pictorial documentation: there are no pictures available.Batch history review: the device quality and manufacturing history records (dhr) have been checked for all available lot numbers and the products found to be according to our specification valid at the time of production.There are 2 similar complaints against the same lot number: 51884096 (1 registered as leading component, 1 registered as involved component).Explanation and rationale: in the light of the little information received and due the circumstance that we did not received the complained devices it is not possible to determine a root cause for the mentioned failure.Corrective action: for this topic (loosening) a product safety case (psc) was initiated.
 
Event Description
It was reported that there was an issue with as vega knee, left side.It was reported that as a result of having the products implanted, the patient has experienced pain and swelling; and normal daily activities were restricted due to the pain.The primary surgery occurred on (b)(6) 2013 and the revision occurred on (b)(6) 2018.Intraoperative findings during replacement surgery were loosening of the tibial and femoral components which resulted in the revision.All available information has been provided at this time, if additional information becomes available the complaint will be updated accordingly.Involved components: nx013z (ps femur cemented f6n lt), nx043 (universal patella p3), nx055z (ps tibia cemented t3), nx131 (ps pe insert t3/t3+, 12mm), nn260p (peek plug f/ tibia).The cement used was zimmer palacos r radiopaque bone cement.The adverse event / malfunction is filed under reference (b)(4).Associated medwatches: 2916714-2020-00531, 2916714-2020-00532, 2916714-2020-00533, 2916714-2020-00534, 2916714-2020-00535.
 
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Brand Name
AS VEGA PS FEMORAL COMP.CEMENTED F6N L
Type of Device
KNEE ENDOPROSTHETICS
Manufacturer (Section D)
AESCULAP AG
po box 40
tuttlingen, 78501
GM  78501
MDR Report Key11117919
MDR Text Key232347134
Report Number2916714-2020-00531
Device Sequence Number1
Product Code HRY
UDI-Device Identifier04046963809942
UDI-Public4046963809942
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Distributor
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 01/05/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/05/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date08/01/2022
Device Model NumberNX013Z
Device Catalogue NumberNX013Z
Device Lot Number51884096
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? Yes
Date Report Sent to FDA01/05/2021
Distributor Facility Aware Date02/15/2019
Event Location Hospital
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage N
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
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