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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: WRIGHT MEDICAL TECHNOLOGY INC INFINITY ADAPTIS TIB SZ4LNG INFINITY ADAPTIS; PROSTHESIS, ANKLE, SEMI-CONSTRAINED, CEMENTED, METAL/POLYMER

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WRIGHT MEDICAL TECHNOLOGY INC INFINITY ADAPTIS TIB SZ4LNG INFINITY ADAPTIS; PROSTHESIS, ANKLE, SEMI-CONSTRAINED, CEMENTED, METAL/POLYMER Back to Search Results
Catalog Number 33680014
Device Problems Device Dislodged or Dislocated (2923); Osseointegration Problem (3003); Migration (4003)
Patient Problems Cyst(s) (1800); Fall (1848); Inadequate Osseointegration (2646); Limb Fracture (4518)
Event Date 01/11/2024
Event Type  Injury  
Manufacturer Narrative
Once the investigation has been completed any additional information will be reported in 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 of the tibial component.It was reported that the patient fell and fractured tibia and dislodged and migrated tibial component.Patient claims it was not due to a fall or noncompliance.After reviewing post-op x-rays and current x-rays, the physician believes patient did in fact fall or was noncompliant.
 
Event Description
The digital stryker prophecy team received a ct scan indicating that the patient may require a revision surgery of the tibial component.It was reported that the patient fell and fractured tibia and dislodged and migrated tibial component.Patient claims it was not due to a fall or noncompliance.After reviewing post-op x-rays and current x-rays, the physician believes patient did in fact fall or was noncompliant.
 
Manufacturer Narrative
Correction - h6 (device code) the reported event could be confirmed, based on available medical records and health care professionals.The device inspection was not possible as the product was not returned for investigation.A review of the device history for the reported lot did not indicate any abnormalities.No corrective actions are required at this time.A review of the labeling did not indicate any abnormalities.Upon further investigation of the ct scans by healthcare professionals the following was observed: after reviewing hcp opinion and surgeon¿s feedback we can conclude that the tibial component shows some radiolucence and some cysts.It is subsidence anteriorly.Loosening and migration could be confirmed.Pe seems attached with components, no sign of breakage or separation.The talar component shows some radiolucence.Loosening is likely possible.There is no clear evidence of migration.Based on investigation, the root cause was attributed to a patient related issue.The patient falling and/or patient non-compliance has been indicated by treating surgeon in this event.The failure is detected by the radiolucence and subsidence of tibial components and radiolucency around talar component.If device is returned or any further information is provided, the investigation report will be reassessed.
 
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Brand Name
INFINITY ADAPTIS TIB SZ4LNG INFINITY ADAPTIS
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 Key18660595
MDR Text Key334778309
Report Number3010667733-2024-00045
Device Sequence Number1
Product Code HSN
UDI-Device Identifier00889797069694
UDI-Public00889797069694
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K181557
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 04/12/2024
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 Number33680014
Device Lot Number1757263
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 01/11/2024
Initial Date FDA Received02/07/2024
Supplement Dates Manufacturer Received03/18/2024
Supplement Dates FDA Received04/12/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured04/25/2023
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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