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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ONKOS SURGICAL ELEOS; TIBIAL STEM EXTENSION CEMENTED 14MMX65MM STRAIGHT FLUTED

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ONKOS SURGICAL ELEOS; TIBIAL STEM EXTENSION CEMENTED 14MMX65MM STRAIGHT FLUTED Back to Search Results
Model Number KSC01465E
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Unspecified Infection (1930); Insufficient Information (4580)
Event Date 03/19/2022
Event Type  Injury  
Manufacturer Narrative
The investigation is in progress.When it is complete a supplemental mdr will be submitted accordingly.Mulitple mdrs were submitted for this adverse event: 3013450937-2022-00135, 3013450937-2022-00137, 3013450937-2022-00138, 3013450937-2022-00139, 3013450937-2022-00140 and 3013450937-2022-00141.
 
Event Description
On (b)(6) 2022 the patient received a superficial wound debridement to treat a superficial suture and sub-q abscess that developed after receiving distal femoral replacement surgery.
 
Manufacturer Narrative
This report is being submitted to include additional information.The investigation is complete.The device was not returned for evaluation.The root cause of the alleged infection could not be determined.If any additional information is obtained, a supplemental mdr will be filed accordingly.The following sections were updated: b4: date of this report added.G3: date received by manufacturer added.G6: type of report added.H2: follow-up type added.H3: device evaluated by manufacturer updated to no.H6: type of investigation code updated to 4110: trend analysis.H6: type of investigation code updated to 4117: device not accessible for testing.H6: investigation findings code updated to 3221: no findings available.H6: investigation conclusions code updated to 4315: cause not established.H10: additional narratives/data.
 
Event Description
On (b)(6) 2022 the patient received a superficial wound debridement to treat a superficial suture and sub-q abscess that developed after receiving distal femoral replacement surgery.
 
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Brand Name
ELEOS
Type of Device
TIBIAL STEM EXTENSION CEMENTED 14MMX65MM STRAIGHT FLUTED
Manufacturer (Section D)
ONKOS SURGICAL
77 east halsey road
parsippany NJ 07054
Manufacturer (Section G)
MICROPORT ORTHOPEDICS
5677 airline road
arlington TN 38002
Manufacturer Contact
danielle pierce
77 east halsey road
parsippany 07054
8447672766
MDR Report Key14138165
MDR Text Key289469731
Report Number3013450937-2022-00136
Device Sequence Number1
Product Code KRO
UDI-Device IdentifierB278KSC01465E0
UDI-PublicB278KSC01465E0
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K161520
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 06/17/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/18/2022
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Model NumberKSC01465E
Device Catalogue NumberKSC01465E
Device Lot Number1856558
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received06/17/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured08/26/2020
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
25000009E ELEOS DISTAL FEMUR RIGHT SEGMENTAL.; 25001210E ELEOS TIBIAL POLY SPACER 10MM.; 25002111E ELEOS DISTAL FEMUR AXIAL PIN.; CS-13120-03M ELEOS SEGMENTAL STEM CEMENTED.; TB-2202E-01M ELEOS TIBIAL BASEPLATE SIZE 2.; THSMWRS01M ELEOS TIBIAL HINGE W/ ROTATIONAL STOP.
Patient Outcome(s) Required Intervention; Hospitalization;
Patient Age77 YR
Patient SexFemale
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