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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ONKOS SURGICAL ELEOS RESURFACING FEMUR AXIAL PIN; PROSTHESIS, KNEE

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ONKOS SURGICAL ELEOS RESURFACING FEMUR AXIAL PIN; PROSTHESIS, KNEE Back to Search Results
Model Number 25002113E
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Unspecified Infection (1930)
Date of Event 04/18/2020
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
This report is for one of three devices involved in this event, please refer to reports: 3013450937-2020-00077 and 3013450937-2020-00079.The device history record and sterilization batch release record were reviewed and indicated that the component involved met specification.The component was unable to be obtained for further analysis.Should additional information be obtained the report will be supplemented.
 
Event or Problem Description
Patient underwent a revision surgery due to an alleged infection.
 
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Brand Name
ELEOS RESURFACING FEMUR AXIAL PIN
Common Device Name
PROSTHESIS, KNEE
Manufacturer (Section D)
ONKOS SURGICAL
77 east halsey road
parsippany, nj
MDR Report Key10078631
Report Number3013450937-2020-00078
Device Sequence Number3300196
Product Code KRO
UDI-Device IdentifierB27825002113E0
UDI-PublicB27825002113E0
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K161520
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2020
Device Explanted Year2020
Reporter Type Manufacturer
Report Source company representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 05/21/2020
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
Operator of Device Health Professional
Device Expiration Date04/25/2025
Device Model Number25002113E
Device Catalogue Number25002113E
Device Lot Number1750625
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/21/2020
Initial Report FDA Received Date05/21/2020
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient Age65 YR
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