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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 Problems Crack (1135); Osseointegration Problem (3003); Insufficient Information (3190); Migration (4003)
Patient Problems Cyst(s) (1800); Inadequate Osseointegration (2646); Insufficient Information (4580)
Event Date 01/08/2024
Event Type  Injury  
Event Description
The digital stryker prophecy team received a ct scan indicating that the patient may require a revision surgery for reasons that are not available at the time of this report.
 
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.
 
Manufacturer Narrative
Correction - h6 (results code).The reported event could be confirmed, based on available ct scans and medical expert assessment.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 "tibial (construct): there is radiolucence visible and there are smaller cysts at the anterior part of the tibial component.Additionally, it looks as if there was a crack in the anterior tibial tray.Therefore loosening and anterior subsidence can be confirmed and there is a potential breakage of the prosthesis (to be confirmed via x-ray-here: insufficient information.) pe: the pe is not separated from the tibial tray.There is no indirect sign of loosening, but it cannot be excluded completely, that damage or dislocation of the pe has taken place.There is insufficient information given, here.Talar (construct): the talar component shows little radiolucence anteriorly.However, there is no clear sign of loosening or migration." based on the available ct scans, cysts around tibial component is observed.Additionally, potential crack of tibial tray is observed in ct scans.However, more detailed information about the complaint event, x-rays as well as the affected device must be available in order to determine the root cause of the complaint event.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 may require a revision surgery for reasons that are not available at the time of this report.
 
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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 Key18632636
MDR Text Key334446821
Report Number3010667733-2024-00040
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 04/13/2024
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 01/08/2024
Initial Date FDA Received02/02/2024
Supplement Dates Manufacturer Received03/19/2024
Supplement Dates FDA Received04/13/2024
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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