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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITH & NEPHEW, INC. JRNY II BCS ART ISRT TRL SZ 3-4 10MM LT; PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL

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SMITH & NEPHEW, INC. JRNY II BCS ART ISRT TRL SZ 3-4 10MM LT; PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL Back to Search Results
Catalog Number 74035242
Medical Device Problem Codes Break (1069); Fracture (1260); Deformation Due to Compressive Stress (2889)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/05/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Internal reference number: (b)(4).
 
Event or Problem Description
It was reported that during a tka surgery one (1) journey fem impact bumper rt and one (1) jrny ii bcs art isrt trl sz 3-4 10mm lt broke after impaction.The procedure was resumed, without any delay, using a s+n back-up device.No injury was reported as a consequence of this issue.
 
Additional Manufacturer Narrative
The associated device was returned and evaluated.The visual inspection revealed that the device broke into two pieces.Both pieces were returned.The visual also reveals the device is heavily gouged, has scratches and a few pieces fractured off.The device shows signs of extreme wear and use.This inspection was conducted by naked eye.A review of the production order did not reveal a manufacturing abnormality that could have caused or contributed to the reported incident.A review of complaint history revealed similar events for the listed device over the previous 12 months, but no similar events for the batch based on the historical data, this failure mode will be monitored for future complaints for any necessary corrective actions.A review of the risk management file revealed this failure mode was previously identified.The anticipated risk level is still adequate.A historical review concluded that there are no prior actions related to this product and event.At this time, we have no evidence to conclude that the product failed to meet any specifications at the time of manufacture.This device is a reusable instrument that can be exposed to numerous surgeries.Damage from prolonged use, misuse or rough handling are likely potential factors that could contribute to the reported event.We recommend that all reusable instruments be routinely inspected for wear and damage and replaced as necessary.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 is warranted for this complaint; however, we will continue to monitor for future complaints and investigate as necessary.We consider this investigation closed.
 
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Brand Name
JRNY II BCS ART ISRT TRL SZ 3-4 10MM LT
Common Device Name
PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL
Manufacturer (Section D)
SMITH & NEPHEW, INC.
1450 brooks rd.
memphis TN 38116
Manufacturer (Section G)
SMITH & NEPHEW, INC.
1450 brooks rd.
memphis TN 38116
Manufacturer Contact
holly topping
7000 west william cannon drive
austin, TX 78735
5123913905
MDR Report Key19873747
Report Number1020279-2024-01479
Device Sequence Number7627756
Product Code JWH
UDI-Device Identifier00885556156933
UDI-Public00885556156933
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K111711
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 08/20/2024
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
Device Catalogue Number74035242
Device Lot Number13DAP3699
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/05/2024
Supplement Date Received by Manufacturer08/19/2024
Initial Report FDA Received Date07/31/2024
Supplement Report FDA Received Date08/22/2024
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured04/26/2013
Is the Device Labeled for Single Use? (Y/N) No
Usage of Device A
Patient Sequence Number1
Patient SexUnknown
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