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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: WRIGHT MEDICAL TECHNOLOGY INC UNKNOWN TIBIAL COMPONENT; PROSTHESIS, ANKLE, SEMI-CONSTRAINED, CEMENTED, METAL/POLYMER

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WRIGHT MEDICAL TECHNOLOGY INC UNKNOWN TIBIAL COMPONENT; PROSTHESIS, ANKLE, SEMI-CONSTRAINED, CEMENTED, METAL/POLYMER Back to Search Results
Catalog Number UNK_WWA
Device Problem Osseointegration Problem (3003)
Patient Problems Inadequate Osseointegration (2646); Implant Pain (4561)
Event Date 02/23/2024
Event Type  Injury  
Manufacturer Narrative
The device is not available for evaluation as it remains implanted in the patient.A review of the device history is not possible because the lot number was not communicated.If additional information becomes available, it will be provided on a supplemental report.
 
Event Description
The digital stryker prophecy team received a ct scan indicating that the patient is experiencing pain and may require a revision surgery of both the tibial and talar components due to tibial component loosening.
 
Manufacturer Narrative
Correction - h6 (results code, conclusion code).The reported event could be confirmed, based on available medical records and health care professionals.The device inspection was not possible as the product was not returned for investigation.The device history record could not be reviewed because the affected device was not returned, and the lot number was not communicated.A review of the labeling did not indicate any abnormalities.Upon further investigation of the ct scans by healthcare professionals the following was observed: after reviewing hcp opinion and surgeon¿s feedback we can conclude that there is radiolucency visible in ct scans of tibial component.Loosening of tibial component could be confirmed.Pe and talar component look well fixed and intact.Based on investigation, the root cause was attributed to a patient related issue.The failure is detected by the radiolucence and loosening of tibial component.If device is returned or any further information is provided, the investigation report will be reassessed.
 
Event Description
The digital stryker prophecy team received a ct scan indicating that the patient is experiencing pain and may require a revision surgery of both the tibial and talar components due to tibial component loosening.
 
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Brand Name
UNKNOWN TIBIAL COMPONENT
Type of Device
PROSTHESIS, ANKLE, SEMI-CONSTRAINED, CEMENTED, METAL/POLYMER
Manufacturer (Section D)
WRIGHT MEDICAL TECHNOLOGY INC
1023 cherry rd
memphis TN 38117
Manufacturer (Section G)
WRIGHT MEDICAL TECHNOLOGY, INC.
11576 memphis arlington rd
arlington TN 38002
Manufacturer Contact
anna jusinski
325 corporate drive
mahwah, NJ 07430
2018315000
MDR Report Key18942710
MDR Text Key338148244
Report Number3010667733-2024-00163
Device Sequence Number1
Product Code HSN
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 05/17/2024
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? No
Device Operator Lay User/Patient
Device Catalogue NumberUNK_WWA
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 02/23/2024
Initial Date FDA Received03/20/2024
Supplement Dates Manufacturer Received04/23/2024
Supplement Dates FDA Received05/17/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Other;
Patient SexFemale
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