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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY ORTHOPAEDICS INC US SIGMA; EARLY INTERVENTION : KNEE TIBIAL INSERT

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DEPUY ORTHOPAEDICS INC US SIGMA; EARLY INTERVENTION : KNEE TIBIAL INSERT Back to Search Results
Catalog Number 102453507
Medical Device Problem Code Difficult to Insert (1316)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 04/20/2026
Type of Reportable Event Malfunction
Event or Problem Description
In the end surgery, they tried to install the insert and it didn't grasp on the tray after several attempts.They took a new insert and achieved the same result.Then they took a slightly higher 1 mm because they didn¿t have more in stock.The same result was achieved.They struggled with the fourth insert and they got it in place.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803 (and/or part 4, as applicable).This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by depuy synthes, or its employees that the report constitutes an admission that the product, depuy synthes, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.Additional narrative: d4: udi: the expiration date is currently not available.Therefore, the full udi is currently not available.
 
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Brand Name
SIGMA
Common Device Name
EARLY INTERVENTION : KNEE TIBIAL INSERT
Manufacturer (Section D)
DEPUY ORTHOPAEDICS INC US
700 orthopaedic drive
warsaw IN 46581 0988
Manufacturer (Section G)
JTE WARSAW MFG SITE
700 orthopaedic drive
warsaw IN 46582
Manufacturer Contact
elba bello
700 orthopaedic dr.
warsaw, IN 46581
9083863534
MDR Report Key25112344
Report Number1818910-2026-08447
Device Sequence Number10280198
Product Code NPJ
UDI-Device Identifier10603295002635
UDI-Public(01)10603295002635(17)310131(10)MG9474
Combination Product (Y/N)N
Initial Reporter CountrySW
PMA/510(K) Number
K233980
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup,Followup
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
Operator of Device Health Professional
Device Catalogue Number102453507
Device Lot NumberLOT: MG9474
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 04/23/2026
Supplement Date Received by Manufacturer06/08/2026
07/21/2026
Initial Report FDA Received Date05/07/2026
Supplement Report FDA Received Date06/09/2026
07/22/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/13/2026
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
Patient SexUnknown
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