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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: EXACTECH, INC. LOGIC FEMORAL PS CEM RIGHT SZ 4; PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL

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EXACTECH, INC. LOGIC FEMORAL PS CEM RIGHT SZ 4; PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL Back to Search Results
Catalog Number 02-010-01-0340
Medical Device Problem Codes Unstable (1667); Naturally Worn (2988); Loosening of Implant Not Related to Bone-Ingrowth (4002)
Health Effect - Clinical Codes Pain (1994); Scar Tissue (2060); Distress (2329); Discomfort (2330); Joint Laxity (4526); Swelling/ Edema (4577); Appropriate Clinical Signs, Symptoms and Conditions Term/Code Not Available (4581)
Date of Event 06/14/2023
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
D10: (b)(6) - 02-012-44-4009 - logic tibia implant psc insert, sz 4, 9mm.Multiple mdr reports were filed for this event, please see associated reports: 1038671-2023-00212.The reason for the revision reported cannot be confirmed from the information provided but may be the result of prosthesis wear, fracture, and femoral loosening or due to inclusion of the polyethylene in the packaging recall.Additionally, a contributing factor to the reported wear may have been the result of being packaged in a non-conforming vacuum bag for more than five years.Potential contributions of user and patient-related considerations to the event could not be assessed as the devices were not available for evaluation and images and radiographs were not provided.If any further information is obtained that would change or alter any information provided, a supplemental report will be filed accordingly.
 
Event or Problem Description
It was reported that approximately 65 months after a right total knee replacement procedure, the patient underwent a revision procedure to address prosthesis fracture, prothesis wear, discomfort, distress, pain and scar tissue.Revision surgery operative notes were provided.Patient left the operating room in stable condition.No further issues or complications were reported.No additional information is available.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional and/or corrected information.The following sections were updated/corrected: h6.Mdr section codes updated/corrected: a, e.The reason for the revision reported cannot be confirmed from the information provided but may be the result of prosthesis wear, fracture, instability, and femoral loosening or due to inclusion of the polyethylene in the packaging recall.Additionally, a contributing factor to the reported wear may have been the result of being packaged in a non-conforming vacuum bag for more than five years.Potential contributions of user and patient-related considerations to the event could not be assessed as the devices were not available for evaluation and images and radiographs were not provided.If any further information is obtained that would change or alter any information provided, a supplemental report will be filed accordingly.
 
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Brand Name
LOGIC FEMORAL PS CEM RIGHT SZ 4
Common Device Name
PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL
Manufacturer (Section D)
EXACTECH, INC.
2320 nw 66 court
gainesville FL 32653
Manufacturer (Section G)
EXACTECH INC.
2320 nw 66th ct
gainesville FL 32653
Manufacturer Contact
geoff gannon
2320 nw 66th ct
gainesville, FL 32653
MDR Report Key21549111
Report Number1038671-2025-01474
Device Sequence Number4419662
Product Code JWH
UDI-Device Identifier10885862001252
UDI-Public10885862001252
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
K033883
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2018
Device Explanted Year2023
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 07/16/2025
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? Yes
Operator of Device Health Professional
Device Expiration Date05/23/2022
Device Catalogue Number02-010-01-0340
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/03/2023
Supplement Date Received by Manufacturer07/15/2025
Initial Report FDA Received Date03/07/2025
Supplement Report FDA Received Date07/16/2025
Date Device Manufactured05/24/2017
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
SEE H11.
Outcome Attributed to Adverse Event Required Intervention; Hospitalization;
Patient SexMale
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