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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MAKO SURGICAL CORP. MCK FEMORAL-LM-RL-SZ 5; PROSTHESIS, KNEE PATELLOFEMOROTIBIAL, PARTIAL, SEMI-CONSTRAINED, CEMENTED, POLYM

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MAKO SURGICAL CORP. MCK FEMORAL-LM-RL-SZ 5; PROSTHESIS, KNEE PATELLOFEMOROTIBIAL, PARTIAL, SEMI-CONSTRAINED, CEMENTED, POLYM Back to Search Results
Catalog Number 180505
Device Problems Loss of Osseointegration (2408); Insufficient Information (3190)
Patient Problem Inadequate Osseointegration (2646)
Event Date 04/04/2016
Event Type  Injury  
Manufacturer Narrative
An evaluation of the device cannot be performed as the device was retained by the hospital and was not returned to the manufacturer.Additional information has been requested.Should additional information become available it will be reported in a supplemental report upon completion of the investigation.Not returned to the manufacturer.
 
Event Description
Dr.(b)(6) revised a patients mako partial knee replacement due to loosening of the femoral component.He changed the femoral component, original size was a 5 left medial, and he downsized to a 4 left medial.He also removed the tibial insert which was originally a 6x9mm, and inserted a 6x10mm.
 
Manufacturer Narrative
An event regarding loosening involving a mck femoral lm-rl sz 5 was reported.The event was not confirmed.Method & results: device evaluation and results: visual, dimensional, and functional inspection were not performed as the item was not returned.Medical records received and evaluation: not performed as medical records were not provided.Device history review: review of the device history records indicates devices were manufactured and accepted into final stock with no reported discrepancies.Complaint history review: there have been no other events for this lot.Conclusions: the event could not be confirmed nor the root cause of the reported event determined due to the minimal information received for evaluation.No further investigation for this event is possible at this time as insufficient information was received by stryker orthopedics.If additional information becomes available, this investigation will be reopened.
 
Event Description
Dr.(b)(6) revised a patients mako partial knee replacement due to loosening of the femoral component.He changed the femoral component, original size was a 5 left medial, and he downsized to a 4 left medial.He also removed the tibial insert which was originally a 6x9mm, and inserted a 6x10mm.
 
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Brand Name
MCK FEMORAL-LM-RL-SZ 5
Type of Device
PROSTHESIS, KNEE PATELLOFEMOROTIBIAL, PARTIAL, SEMI-CONSTRAINED, CEMENTED, POLYM
Manufacturer (Section D)
MAKO SURGICAL CORP.
2555 davie road
fort lauderdale FL 33317
Manufacturer (Section G)
MAKO SURGICAL CORP.
2555 davie road
fort lauderdale FL 33317
Manufacturer Contact
keyla colon
325 corporate drive
mahwah, NJ 07430
2018315000
MDR Report Key5620977
MDR Text Key44117734
Report Number3005985723-2016-00134
Device Sequence Number1
Product Code NPJ
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K090763
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 04/04/2016
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 Expiration Date08/31/2015
Device Catalogue Number180505
Device Lot Number14250610
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 04/04/2016
Initial Date FDA Received04/29/2016
Supplement Dates Manufacturer ReceivedNot provided
Supplement Dates FDA Received07/12/2016
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured09/15/2010
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) Required Intervention;
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