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Lot Number UNKNOWN
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Loss of Range of Motion (2032); Arthralgia (2355); Swelling/ Edema (4577); Appropriate Clinical Signs, Symptoms, Conditions Term / Code Not Available (4581)
Event Date 12/09/2021
Event Type  Injury  
Manufacturer Narrative
(b)(6) company comment dated (b)(6) 2021: this case concerns a patient who received treatment with hylan g-f 20, sodium hyaluronate but was unable to bend the knee, had difficulty putting weight on the knee, pain in left knee and swelling in left knee. Based on the temporal relationship, causal relationship of the device in the occurrence of events cannot be denied. However, further information regarding patient¿s concomitant medications and technique used while administration of injection precludes complete medical assessment of the case.
Event Description
Inability to bend the knee [joint range of motion decreased]. Difficulty putting weight on the knee [weight bearing difficulty]. Pain in left knee [aching (l) knee]. Swelling in left knee [swelling of l knee]. Case narrative: initial information from united states received on 15-dec-2021 regarding an unsolicited valid serious case received from a consumer/non-healthcare professional. This case involves (b)(6) years old female patient who reported inability to bend the knee, difficulty putting weight on the knee, pain in left knee and swelling in left knee while being treated with medical device hylan g-f 20, sodium hyaluronate [synvisc one]. The patient's past medical history included meniscal surgery in the knee, several injections of corticosteroid into the knee, and an injury to the right knee. Patient also mentioned that she had been treating her behcet's disease with colchicine for 30 years. The patient's past medical treatment included (b)(6)covid-19 vaccine in (b)(6) 2021. The patient's past vaccination(s) and family history were not provided. Concomitant medications included colchicine for behcet's disease. On (b)(6) 2021, the patient received hylan g-f 20, sodium hyaluronate solution for injection (strength: 48 mg) at a dose of 48 mg once for osteoarthritis (lot and route: unknown) with a 21 g needle in left knee. The reporter stated that the left knee felt good at first, after the injection, but then about 24 hours later (on (b)(6) 2021; latency: 1 day), the patient began to experience, in the left knee, pain (arthralgia), swelling (joint swelling), and an inability to bend the knee (joint range of notion decreased), and difficulty putting weight on the knee (weight bearing difficulty), but no fever. All the events were assessed as serious as intervention was required for the events. Patient had started a course of a medrol dose pack, and she did use ice on the knee, and now was using heat on the knee, and stated that the knee had improved some from its worst point. Patient stated that for 4 days she was not able to bend the left knee at all, but that now she was able to bend her knee to about a 90-degree angle, but cannot bent it any more than that, and it was still swollen and painful, and still difficult to put weight on the left knee. Action taken: not applicable for all events the patient was treated with methylprednisolone (medrol) for all events. At time of reporting, the outcome was recovering / resolving for all events.
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Type of DeviceMOZ
Manufacturer (Section D)
1125 pleasantview terrace
ridgefield 07657
Manufacturer (Section G)
1125 pleasantview terrace
ridgefield 07657
Manufacturer Contact
heather schiappacasse
55 corporate drive, ms 55b-220
bridgewater 08807
MDR Report Key13085058
MDR Text Key288280193
Report Number2246315-2021-00182
Device Sequence Number1
Product Code MOZ
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Consumer,Health Professional
Reporter Occupation
Type of Report Initial,Followup
Report Date 01/13/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/24/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Was Device Evaluated by Manufacturer? No Answer Provided
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial

Patient Treatment Data
Date Received: 12/24/2021 Patient Sequence Number: 1