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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY IRELAND - 9616671 ATTUNE RP TIB BASE SZ 3 CEM; KNEE TIBIAL TRAY

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DEPUY IRELAND - 9616671 ATTUNE RP TIB BASE SZ 3 CEM; KNEE TIBIAL TRAY Back to Search Results
Catalog Number 150680003
Device Problem Loss of or Failure to Bond (1068)
Patient Problem Pain (1994)
Event Date 01/23/2024
Event Type  Injury  
Manufacturer Narrative
Product complaint # (b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803 (and/or part 4, as applicable).This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by depuy synthes, or its employees that the report constitutes an admission that the product, depuy synthes, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.
 
Event Description
Surgeon said the patient complained of pain months after their primary knee surgery.He thought they may have aeseptic loosening since they did not show any signs of infection.He removed all components and waited on cultures to make sure the patient was not infected and replaced implants with attune revision components.All components seemed to be cemented on well.Bone and cement were still on the flat part of the tibial tray.Sales rep did not observe any cement on the cone of the tibial component.No one mentioned their being any problems with our implants.It was unknown about surgical delay.Doi: (b)(6) 2022.Dor: (b)(6) 2024.Affected side: right knee.
 
Manufacturer Narrative
Product complaint # (b)(4).Investigation summar: no device associated with this report was received for examination.An evaluation of the manufacturing record could not be performed as the required lot number was not provided to complete the evaluation.As part of our company quality system process, all devices are manufactured, inspected, and distributed to approved specifications.Additional complaint information monitoring for potential safety signals will be conducted through complaint trending as part of the post-market surveillance.If additional information is made available, the investigation will be updated as applicable.Device history lot: a non-conformance search for the provided lot number/product code combination was conducted and no reports related to the reported event were found.
 
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Brand Name
ATTUNE RP TIB BASE SZ 3 CEM
Type of Device
KNEE TIBIAL TRAY
Manufacturer (Section D)
DEPUY IRELAND - 9616671
loughbeg ringaskiddy co.
cork
EI 
Manufacturer (Section G)
JTE WARSAW MFG SITE
700 orthopaedic drive
warsaw IN
Manufacturer Contact
kate karberg
700 orthopaedic dr.
warsaw, IN 46581-0988
3035526892
MDR Report Key18613448
MDR Text Key334204856
Report Number1818910-2024-02090
Device Sequence Number1
Product Code NJL
UDI-Device Identifier10603295492153
UDI-Public10603295492153
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P830055
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 01/31/2024
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? Yes
Device Operator Health Professional
Device Catalogue Number150680003
Device Lot Number9929203
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 01/23/2024
Initial Date FDA Received01/31/2024
Supplement Dates Manufacturer Received02/13/2024
Supplement Dates FDA Received02/15/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured11/22/2021
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
ATTUNE PS FEM RT SZ 4 CEM; ATTUNE PS RP INSRT SZ 4 8MM; DEPUY1 GENTAMICIN CEMENT 40G; DEPUY1 GENTAMICIN CEMENT 40G
Patient Outcome(s) Required Intervention;
Patient Age58 YR
Patient SexFemale
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