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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MAKO SURGICAL CORP. CEMENT REMOVAL TOOL; PROSTHESIS, KNEE PATELLOFEMOROTIBIAL, PARTIAL, SEMI-CONSTRAINED, CEMENTED, POLYM

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MAKO SURGICAL CORP. CEMENT REMOVAL TOOL; PROSTHESIS, KNEE PATELLOFEMOROTIBIAL, PARTIAL, SEMI-CONSTRAINED, CEMENTED, POLYM Back to Search Results
Catalog Number 120095
Device Problems Break (1069); Fracture (1260)
Patient Problems No Consequences Or Impact To Patient (2199); No Known Impact Or Consequence To Patient (2692)
Event Date 05/06/2019
Event Type  malfunction  
Manufacturer Narrative
It was noted that the device is not available for evaluation.Should additional information become available, it will be provided in a supplemental report upon completion of the investigation.Device not returned.
 
Event Description
The cement scraper was being used to pick a piece of hard cement off and was bent, upon trying to return it to its normal shape, the end of the scraper broke off.Case type: tka.
 
Manufacturer Narrative
It was reported that "the cement scraper was being used to pick a piece of hard cement off and was bent, upon trying to return it to its normal shape, the end of the scraper broke off." the event was not confirmed.Method & results: -device evaluation and results: not performed as the device(s) were not available for evaluation.-product history review: review of the device history records indicates (b)(4) were manufactured and accepted into final stock on 17aug2018 with no reported discrepancies.-complaint history review: a review of complaints in catsweb and trackwise related to p/n 120095, lot 06110818 shows 06 additional complaint(s) related to the failure in this investigation.Conclusion: the exact cause of the event could not be determined because the device was not available for evaluation.No further investigation for this event is possible at this time as no devices and / or insufficient information was received by the investigator.If devices and / or additional information become available, this investigation will be reopened.
 
Event Description
The cement scraper was being used to pick a piece of hard cement off and was bent, upon trying to return it to its normal shape, the end of the scraper broke off.Case type: tka.
 
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Brand Name
CEMENT REMOVAL TOOL
Type of Device
PROSTHESIS, KNEE PATELLOFEMOROTIBIAL, PARTIAL, SEMI-CONSTRAINED, CEMENTED, POLYM
Manufacturer (Section D)
MAKO SURGICAL CORP.
2555 davie road
fort lauderdale FL 33317
MDR Report Key8658162
MDR Text Key146644158
Report Number3005985723-2019-00398
Device Sequence Number1
Product Code NPJ
UDI-Device Identifier00848486018092
UDI-Public00848486018092
Combination Product (y/n)N
PMA/PMN Number
K090763
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Type of Report Initial,Followup
Report Date 12/20/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/31/2019
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number120095
Device Lot Number06110818
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/18/2019
Date Manufacturer Received11/21/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient Outcome(s) Other;
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