MAUDE Adverse Event Report: ARTHREX, INC. BUTTON, DOG BONE; WASHER, BOLT NUT

Model Number BUTTON, DOG BONE

Device Problem Appropriate Term/Code Not Available (3191)

Patient Problems Bacterial Infection (1735); Fatigue (1849); Pain (1994); Pleural Effusion (2010); Sweating (2444); Weight Changes (2607)

Event Date 06/12/2020

Event Type  Injury  

Manufacturer Narrative

The contribution of the device to the reported event could not be determined as the device was not returned for evaluation.The root cause of the event could not be determined from the information available and without device evaluation.

Event Description

It was reported that the patient had undergone a revision acl procedure on (b)(6) 2020.During the procedure a lifenet fgl was used.Patient had developed an infection.Surgeon washed out the knee.So far nothing has grown on cultures, but he will have to take the allograft out if the patient doesn¿t get better.The reporter also copied lifenet in on their initial report to arthrex.Graft id: 1913080-1009.Additional information provided on 7/8/2020: the physician reported the patient had a prior acl surgery many years ago (>7) and a revision was performed on (b)(6) 2020.No evidence of any prior osteo or infection in the past.The primary surgery was performed by a different surgeon.The surgeon cannot confirm if arthrex products were used during the primary procedure.The patient decided to have it finally revised, but had been living without their acl for awhile.The index revision acl surgery was on (b)(6) 2020.Washout was performed one week later on (b)(6) 2020.No implants were explanted at the time of the washout.The following arthrex products were implanted during the revision surgery; fgl // graft id: 1913080-1009.Ar-1588tn-1 // lot: 10655198.Ar-1588btb // lot: 10591147.Ar-2270 // lot: 10779787.Following the revision surgery; the patients symptoms were fevers, night sweats and feeling ill, malaise, weight loss, knee pain and effusion.The patient had elevated esr and crp.Some bacteria noted in the cell count but never grew anything from all the multiple cultures.The patient responded better to iv abx with ceftriaxone via a picc line.The patient is doing better, but still having some night sweats.Knee is looking and feeling better.Due to the unusual presentation and lack of culture results, the surgeon and the id consultants are concerned about possible contaminated graft or possible mycobacteria, etc.

• Brand Name: BUTTON, DOG BONE
• Type of Device: WASHER, BOLT NUT
• Manufacturer (Section D): ARTHREX, INC.; 1370 creekside boulevard; naples FL 34108 1945
• Manufacturer (Section G): ARTHREX, INC.; 1370 creekside boulevard; naples FL 34108 1945
• Manufacturer Contact: vik bajnath ; 8009337001
• MDR Report Key: 10308386
• MDR Text Key: 200454836
• Report Number: 1220246-2020-01966
• Device Sequence Number: 1
• Product Code: HTN
• UDI-Device Identifier: 00888867026599
• UDI-Public: 00888867026599
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K052276
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,distri
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 07/22/2020

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 Model Number: BUTTON, DOG BONE
• Device Catalogue Number: AR-2270
• Device Lot Number: 10779787
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 06/29/2020
• Initial Date FDA Received: 07/22/2020
• Was Device Evaluated by Manufacturer?: No
• Date Device Manufactured: 03/31/2020
• Is the Device Single Use?: Yes
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Other