MAUDE Adverse Event Report: SMITH & NEPHEW, INC. LGN COUNTERBORE REAMER; PROSTHESIS, KNEE, FEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, METAL/POLYMER

Model Number	71434308
Medical Device Problem Code	Insufficient Device Problem Information (3190)
Health Effect - Clinical Code	No Known Impact Or Consequence To Patient (2692)
Date of Event	06/25/2020
Type of Reportable Event	Serious Injury
Event or Problem Description
It was reported that on tka due to unspecified functional failure, the surgeon shifted from using an offset due to ¿sub optimal¿ bone removal.The procedure was finished in a change of surgical technique.No delay.All available information has been disclosed.If additional information should become available, a supplemental report will be submitted accordingly.
Additional Manufacturer Narrative
Sections b, d and h updated.
Event or Problem Description
It was reported that on a revision from a competitor's device, the surgeon shifted from using an offset due to ¿sub optimal¿ bone removal.Reamer was to dull and surgeon was afraid of fracture.Procedure started using the lgn counterbore reamer but it then was no longer needed.The procedure was finished in a change of surgical technique.All components were pulled and replaced with legion revision.No delay.All available information has been disclosed.If additional information should become available, a supplemental report will be submitted accordingly.
Additional Manufacturer Narrative
The device, used in treatment, was not returned for evaluation and the reported event could not be confirmed.The clinical/medical investigation concluded that, this case reports that a competitor implant was revised to a s&n device.During implantation, the surgeon shifted from using an offset due to ¿sub optimal¿ bone removal, as he felt the reamer was too dull.The procedure was completed using a change of surgical technique.Per complaint details, there was no injuries to patient, and no delay.Therefore, no further assessment is warranted at this time.A review of the manufacturing records did not reveal a manufacturing abnormality that could have caused or contributed to the reported incident.A review of complaint history did not reveal additional complaints for the listed batch.A review of the risk management file revealed this failure mode was previously identified.At this time, we have no reason to suspect that the product failed to meet any product specifications at the time of manufacture.This device is a reusable instrument that can be exposed to numerous surgeries.Damage from prolonged use, misuse or rough handling are likely probable causes of the reported event.We recommend that all reusable instruments be routinely inspected for wear and damage and replaced as necessary.Based on this investigation, the need for corrective action is not indicated.Without the return of the actual product involved, our investigation could not proceed.Should the device or additional information be received, the complaint will be reopened.No further investigation is warranted for this complaint; however, we will continue to monitor for future complaints and investigate as necessary.We consider this investigation closed.

• Brand Name: LGN COUNTERBORE REAMER
• Common Device Name: PROSTHESIS, KNEE, FEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, METAL/POLYMER
• Manufacturer (Section D): SMITH & NEPHEW, INC.; 1450 brooks rd.; memphis TN 38116
• MDR Report Key: 10299994
• Report Number: 1020279-2020-03374
• Device Sequence Number: 18961839
• Product Code: HRY
• UDI-Device Identifier: 03596010549679
• UDI-Public: 03596010549679
• Combination Product (Y/N): N
• Initial Reporter Country: US
• PMA/510(K) Number: K121393
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: company representative,user f
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 08/14/2021

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?: Yes
• Operator of Device: Health Professional
• Device Model Number: 71434308
• Device Catalogue Number: 71434308
• Device Lot Number: 13JM12143
• Was Device Available for Evaluation?: No
• Initial Date Received by Manufacturer: 06/25/2020
• Supplement Date Received by Manufacturer: 07/24/2020; 08/13/2021
• Initial Report FDA Received Date: 07/20/2020
• Supplement Report FDA Received Date: 07/28/2020; 08/14/2021
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention