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MAUDE Adverse Event Report: ENCORE MEDICAL LP DJO SURGICAL; 44MM RSP GLEN HD +8MM,
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ENCORE MEDICAL LP DJO SURGICAL; 44MM RSP GLEN HD +8MM,
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Model Number
508-44-101
Medical Device Problem Code
Unstable (1667)
Health Effect - Clinical Code
Joint Laxity (4526)
Date of Event
02/16/2026
Type of Reportable Event
Serious Injury
Event or Problem Description
Instability.
Additional Manufacturer Narrative
Complaint has been evaluated and is similar to report number (b)(4); s814 - stability, poor joint, revision surgery.If additional information regarding the reported event is submitted at a future date, this investigation will be re-evaluated.
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Brand Name
DJO SURGICAL
Common Device Name
44MM RSP GLEN HD +8MM,
Manufacturer
(Section D)
ENCORE MEDICAL LP
9800 metric blvd.
austin TX 78758
Manufacturer
(Section G)
ENCORE MEDICAL, LP
9800 metric blvd
austin TX 78758
Manufacturer Contact
stacey bonnell
9800 metric blvd.
austin, TX 78758
8003219549
MDR Report Key
24610083
Report Number
1644408-2026-00454
Device Sequence Number
21366788
Product Code
KWS
UDI-Device Identifier
00888912024785
UDI-Public
00888912024785
Combination Product (Y/N)
N
Initial Reporter State
NJ
Initial Reporter Country
US
PMA/510(K) Number
K100741
Number of Events Summarized
1
Summary Report (Y/N)
N
Device Explanted Year
2026
Serviced by Third Party (Y/N)
N
Reporter Type
Manufacturer
Report Source
Company Representative
Initial Reporter Occupation
Non-Healthcare Professional
Type of Report
Initial
Report Date
(Section B)
03/16/2026
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 Model Number
508-44-101
Was Device Available for Evaluation?
No
Type of Report(Section G)
Thirty-Day
Initial Date Received by Manufacturer
02/16/2026
Initial Report FDA Received Date
03/16/2026
Was Device Evaluated by Manufacturer? (Y/N)
No
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 Number
1
Concomitant Medical Products
and Therapy/Usage Dates
509-02-044 UNKNOWN.
Outcome Attributed to Adverse Event
Required Intervention;
Patient Age
68 YR
Patient Sex
Male
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