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U.S. Department of Health and Human Services

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

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WRIGHT MEDICAL TECHNOLOGY INC UNKNOWN INFINITY TIBIAL COMPONENT; PROSTHESIS, ANKLE, SEMI-CONSTRAINED, CEMENTED, METAL/POLYMER Back to Search Results
Catalog Number UNK_WWA
Device Problems Adverse Event Without Identified Device or Use Problem (2993); Migration (4003)
Patient Problems Cyst(s) (1800); Damage to Ligament(s) (1952); Inadequate Osseointegration (2646); Limb Fracture (4518)
Event Date 07/10/2023
Event Type  Injury  
Event Description
The digital stryker prophecy team received a ct scan indicating that the patient may require a revision surgery due to the talus collapsing posteriorly.
 
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.H3 other text : device remains implanted in patient.
 
Event Description
The digital stryker prophecy team received a ct scan indicating that the patient may require a revision surgery due to the talus collapsing posteriorly.
 
Manufacturer Narrative
Correction - d1 (product long description), h6 (clinical codes, device code, results code and conclusion code).The reported event could be confirmed, based on available medical record 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: there is radiolucence, subsidence and a periprosthetic fracture visible in the ct scan.The implant is loosened and has migrated together with the pe.The tibial implant is also subsided and migrated inferior-posteriorly, there is radiolucence and cysts and a fracture visible at the posterior end of the talus.Based on investigation, the root cause was attributed to a patient related issue.The cause of failure is due to radiolucence and cavities around tibial and talar components.Also, facture in talus was observed.If the device is returned or any further information is provided, the investigation report will be reassessed.
 
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Brand Name
UNKNOWN INFINITY 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 Key17451906
MDR Text Key320318739
Report Number3010667733-2023-00424
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 10/18/2023
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 07/10/2023
Initial Date FDA Received08/03/2023
Supplement Dates Manufacturer Received09/20/2023
Supplement Dates FDA Received10/18/2023
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 Age65 YR
Patient SexMale
Patient Weight120 KG
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