MAUDE Adverse Event Report: AESCULAP AG AS; PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL

Model Number	NR188Z
Medical Device Problem Code	Mechanical Problem (1384)
Health Effect - Clinical Code	Loss of Range of Motion (2032)
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
Investigation on-going.Should relevant additional information / investigation results become available, a supplemental medwatch report will be submitted.
Event or Problem Description
It was reported to aesculap inc.That a as tibia offset stem d18x132 cementless (part# nr188z) was implanted on (b)(6) 2021.According to the complaint description, a surgery to replace the polyethylene component(s) had been planned.Debridement of scarring on the right knee would also be performed.The patient experienced decreased range of motion in the right knee and pain.The polyethylene replacement would likely be smaller in size.The procedure was planned for (b)(6) 2025.The adverse event is filed under aic reference (b)(4).Associated medwatch reports 3005673311-2025-00010, 3005673311-2025-00012, 3005673311-2025-00013, 3005673311-2025-00014, 3005673311-2025-00015, 3005673311-2025-00016, 3005673311-2025-00017, 3005673311-2025-00018.
Additional Manufacturer Narrative
Corrected information: a2 patient age.Additional information: a3a patient sex.Manufacturing site evaluation: the device was not returned to the manufacturer for physical evaluation.Additionally, no on-site evaluation of the unit was performed and no parts were returned for failure analysis.Therefore, the investigation was not able to confirm a device issue that could be associated with the reported event.The device history records (dhr) were reviewed for the available lot number; the device was found to be within specification at the time of production.All device history records (dhr) are reviewed and released according to documented procedures and a device is not released if it does not meet requirements or is nonconforming.A definitive conclusion regarding the complaint incident cannot be reached without a physical examination of the complaint device.

• Brand Name: AS
• Common Device Name: PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL
• Manufacturer (Section D): AESCULAP AG; po box 40; tuttlingen, 78501 ; GM 78501
• MDR Report Key: 21741260
• Report Number: 3005673311-2025-00011
• Device Sequence Number: 4007369
• Product Code: JWH
• UDI-Device Identifier: 04046963176433
• UDI-Public: (01)04046963176433(11)180919(17)280831(10)52463448
• Combination Product (Y/N): N
• Initial Reporter State: OK
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2021
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Importer
• Initial Reporter Occupation: Nurse
• Type of Report: Initial,Followup
• Report Date (Section B): 04/11/2025
• Report Date (Section F): 04/01/2025

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 Model Number: NR188Z
• Device Catalogue Number: NR188Z
• Device Lot Number: 52463448
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: Yes
• Distributor Facility Aware Date: 03/11/2025
• Device Age: 6 YR
• Event Location: Hospital
• Date Report to Manufacturer: 03/12/2025
• Type of Report(Section G): Follow-Up
• Initial Date Received by Manufacturer: Not provided
• Supplement Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 04/01/2025
• Supplement Report FDA Received Date: 04/11/2025
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Age: 65 YR
• Patient Sex: Male
• Date Report Sent to FDA: 04/01/2025