| 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 | 24971207 |
| Report Number | 24971207 |
| Device Sequence Number | 10455635 |
| Product Code |
JWH
|
| UDI-Device Identifier | 04046963655808 |
| UDI-Public | (01)04046963655808(11)211122(17)311121(10)52728599 |
| Combination Product (Y/N) | N |
| Initial Reporter State | GA |
| Initial Reporter Country | US |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2022 |
| Device Explanted Year | 2026 |
| Reporter Type |
User Facility
|
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial,Followup,Followup |
| Report Date (Section B) |
08/12/2026 |
| Report Date (Section F) |
08/12/2026 |
| 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? |
Yes
|
| Operator of Device |
Health Professional
|
| Device Model Number | NX060Z |
| Device Catalogue Number | NX060Z |
| Device Lot Number | 52728599 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Was the Report Sent to FDA? |
Yes
|
| Device Age | 54 MO |
| Event Location |
Hospital
|
| Date Report to Manufacturer | 03/27/2026 |
| Initial Date Received by Manufacturer | Not provided |
| Supplement Date Received by Manufacturer | Not provided Not provided
|
| Initial Report FDA Received Date | 04/23/2026 |
| Supplement Report FDA Received Date | 05/19/2026 08/12/2026
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
N
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Sex | Female |
| Patient Weight | 205 LB |
| Patient Race | White |
| Date Report Sent to FDA | 04/23/2026 |
|
|