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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITH & NEPHEW, INC. JRNY II TKA FEM TRIAL LT SZ 5; PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/META

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SMITH & NEPHEW, INC. JRNY II TKA FEM TRIAL LT SZ 5; PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/META Back to Search Results
Model Number 74031225
Medical Device Problem Code Nonstandard Device (1420)
Health Effect - Clinical Codes No Patient Involvement (2645); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/29/2020
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during a training lab at the office, it was noted that there is a burr in the sliding track of the trial.The box cut guide will not properly slide into place because of this burr.Also, the device exhibits signs of wear and tear.No surgery or patient were involved.
 
Additional Manufacturer Narrative
The device, intended use in treatment, was returned for evaluation.A visual inspection confirmed the rails are cracked on the jrny ii tka fem trial lt sz 5.The device shows significant signs of wear/usage.A review of the manufacturing records did not reveal a manufacturing abnormality that could have caused or contributed to the reported incident.At this time, we have no reason to suspect that the products failed to meet any product specifications at the time of manufacture.A review of complaint history for the listed part revealed no prior complaints for the listed batch mode.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.This is a reusable instrument that can be exposed to numerous surgeries; damage from repeated use can occur.Based on this investigation, the need for corrective action is not indicated.Should additional information be received, the complaint will be reopened.No further investigation warranted for this complaint; however we will continue to monitor for future complaints and investigate as necessary.
 
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Brand Name
JRNY II TKA FEM TRIAL LT SZ 5
Common Device Name
PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/META
Manufacturer (Section D)
SMITH & NEPHEW, INC.
1450 brooks rd.
memphis TN 38116
MDR Report Key10437488
Report Number1020279-2020-04132
Device Sequence Number2671024
Product Code JWH
UDI-Device Identifier03596010671967
UDI-Public03596010671967
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
K121443
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source company representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 12/04/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model Number74031225
Device Catalogue Number74031225
Device Lot Number16MBG0020
Was Device Available for Evaluation? Yes
Initial Date Received by Manufacturer 07/29/2020
Supplement Date Received by Manufacturer12/01/2020
Initial Report FDA Received Date08/21/2020
Supplement Report FDA Received Date12/05/2020
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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