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Model Number HTO IMPL,IBAL LG 8°/X-LG 7°
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Autoimmune Disorder (1732); Diarrhea (1811); Fatigue (1849); Headache (1880); Itching Sensation (1943); Memory Loss/Impairment (1958); Pain (1994); Rash (2033); Staphylococcus Aureus (2058); Tinnitus (2103); Sleep Dysfunction (2517); Cognitive Changes (2551); Test Result (2695)
Event Date 04/01/2019
Event Type  Injury  
Manufacturer Narrative
The contribution of the device to the reported event could not be determined as the device was not returned for evaluation. The root cause of the event could not be determined from the information available and without device evaluation.
Event Description
It was reported that the patient underwent a (b)(6) 2019 right knee tibial osteotomy. Approximately 3 months after surgery patient was all healed but had developed some pain from physical therapy on top of his knee from overuse. Surgeon prescribed topical ointment. Patient was allergic to the ointment and his knee swelled up and was itchy. Patient developed a staff infection from the outside under the skin. A cleanout surgery performed (b)(6) 2019. Everything was fine from there. Patient had to take antibiotics approximately 4 months intravenously to prevent infections. No infections ever occurred. Approximately 6 months post (b)(6) 2019 tibial osteotomy patient began having symptoms that have progressively become worse. Symptoms are as follows: tinnitus: started a few month post (b)(6) 2019 surgery and is now at a level of being unbearable. Patient actually runs leaf blower outside to help drown out the tinnitus noise because he cannot take it. This has been ongoing and has never stopped. It only continues to worsen. Gout like symptoms: patient has had several attacks. In the beginning it was thought patient was having a heart attack. His heart was racing and then mysteriously would go back to normal accompanied by kidney pain and ankle pain. Doctor thought it was gout or gout crystals but nothing ever showed that. The episodes would come and about once a month after surgery. Patient went to the infectious disease doctor about it but nothing ever showed up. Fatigue: patient's sleep patterns have changed causing him to wake up around 4:30/5:oo and he can only work until about noon. At that point he starts getting foggy brain and fatigued. This has worsened over time and patient has to lie down every day as his head is in too much pain. Red bumps on the crown of patient's head: these have not gone away or formed into anything and they are extremely itchy. Headaches: the headaches began about 6 - 8 months prior to report to arthrex and have not stopped. They are not migraines as patient's neurologist has tested the patient. The headaches are constant with no relief. The headaches are about an 8 on a pain scale. Dementia like symptoms: besides head fog, the patient does not remember simple things like the type of sandwich he eats every day, or forgets every day words like "refrigerator". When patient is talking his mind will go blank. Upset stomach: burping and the feeling of throwing up yet patient never actually vomits. Patient also has loss of appetite. Diarrhea: patient goes through periods of non-stop diarrhea. Patient will have it for two weeks at a time and then it will go away but then reappear again on and off. Most of this has started pre-covid 19 however, patient has been tested several times for covid19. All tests to date have been negative, including the lp test. Patient has had a spinal tap and has seen the infectious disease doctor from his surgery. Patient has been on many different sleep medicines, gout medicines, headache, ear tests and lyme disease tests. All test results not back yet but protein count is high along with high white blood count. Surgeon is aware of what is going on with the patient. Prior to surgery patient was a generally healthy individual, a professional cyclist, took no medication, weighed (b)(6) (depending on cycling season) and is 5'1". Now patient has days he can barely walk and now shuffles because his head pain is so severe. He is usually lying down. When he sits up the headaches are more severe. When patient stands he gets disoriented and the fog and headaches and tinnitus become more severe. Concern from reporter and patient is that patient is allergic to the implants/osteotomy wedge and may be causing an immune disorder.
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Manufacturer (Section D)
1370 creekside boulevard
naples FL 34108 1945
Manufacturer (Section G)
1370 creekside boulevard
naples FL 34108 1945
Manufacturer Contact
vik bajnath
MDR Report Key10934357
MDR Text Key219157024
Report Number1220246-2020-02371
Device Sequence Number1
Product Code HRS
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type other
Reporter Occupation Administrator/Supervisor
Type of Report Initial
Report Date 12/02/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/02/2020
Is this an Adverse Event Report? Yes
Device Operator
Device Model NumberHTO IMPL,IBAL LG 8°/X-LG 7°
Device Catalogue NumberAR-13400L-08
Device Lot Number10202129
Was Device Available for Evaluation? No
Is the Reporter a Health Professional?
Was the Report Sent to FDA?
Event Location No Information
Date Manufacturer Received11/09/2020
Was Device Evaluated by Manufacturer? No
Date Device Manufactured04/06/2018
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device?
Type of Device Usage Initial

Patient Treatment Data
Date Received: 12/02/2020 Patient Sequence Number: 1