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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ONKOS SURGICAL ELEOS; CEMENTED STEM EXTENSION, 15X30MM

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ONKOS SURGICAL ELEOS; CEMENTED STEM EXTENSION, 15X30MM Back to Search Results
Model Number KSC01530E
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Unspecified Infection (1930)
Date of Event 02/27/2023
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
The investigation is in process.The device will not be returned for evaluation.When the investigation is complete, a supplemental mdr will be submitted accordingly.Multiple mdrs were submitted for this event: #3013450937-2023-00044.#3013450937-2023-00045.#3013450937-2023-00047.#3013450937-2023-00048.#3013450937-2023-00049.#3013450937-2023-00050.The following mdrs were submitted for the same patient: #3013450937-2020-00059 #3013450937-2020-00060 #3013450937-2020-00061 #3013450937-2020-00062.
 
Event or Problem Description
It was reported that the patient developed an alleged infection.The patient underwent a revision surgery on (b)(6) 2023 where the following eleos implants were revised: distal femur, tibial hinge component, poly spacer, and distal femur axial pin.The following eleos implants remained implanted during the revision surgery: segmental stem, tibial baseplate, and stem extension.No additional information regarding this adverse event has been reported.
 
Event or Problem Description
It was reported that the patient developed an alleged infection.The patient underwent a revision surgery on (b)(6) 2023 where the following eleos implants were revised: distal femur, tibial hinge component, poly spacer, and distal femur axial pin.The following eleos implants remained implanted during the revision surgery: segmental stem, tibial baseplate, and stem extension.No additional information regarding this adverse event has been reported.
 
Additional Manufacturer Narrative
The investigation is complete.It was determined that the returned devices could not be furher evaluated.The device history records and sterilization batch records were reviewed and no issues during manufacturing or sterilization were identified that would have contributed to this complaint.If additional information is received, a supplemental mdr will be submitted accordingly.
 
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Brand Name
ELEOS
Common Device Name
CEMENTED STEM EXTENSION, 15X30MM
Manufacturer (Section D)
ONKOS SURGICAL
77 east halsey road
parsippany NJ 07054
Manufacturer (Section G)
MICROPORT ORTHOPEDICS
5677 airline rd
arlington TN 38002
Manufacturer Contact
sara dailey
77 east halsey road
parsippany, NJ 07054
9732645400
MDR Report Key16616289
Report Number3013450937-2023-00046
Device Sequence Number4855259
Product Code KRO
UDI-Device IdentifierB278KSC01530E0
UDI-PublicB278KSC01530E0
Combination Product (Y/N)N
Initial Reporter StateSC
Initial Reporter CountryUS
PMA/510(K) Number
K161520
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2019
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 03/27/2023
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? No
Operator of Device Health Professional
Device Expiration Date03/21/2025
Device Model NumberKSC01530E
Device Catalogue NumberKSC01530E
Device Lot Number1701875
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/23/2023
Supplement Date Received by Manufacturer03/24/2023
Initial Report FDA Received Date03/24/2023
Supplement Report FDA Received Date03/27/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured03/21/2017
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
P/N 25000009E, ELEOS DISTAL FEMUR; P/N 25001210E, ELEOS TIBIAL POLY SPACER; P/N 25002100E, ELEOS TIBIAL HINGE COMPONENT; P/N 25002111E, ELEOS DISTAL FEMUR AXIAL PIN; P/N 25002204E, ELEOS TIBIAL BASEPLATE; P/N CS-15120-03M, ELEOS SEGMENTAL STEM
Outcome Attributed to Adverse Event Hospitalization;
Patient Age86 YR
Patient SexFemale
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