| Brand Name | AS VEGA SYSTEM® PS |
| Common Device Name | PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/META |
| Manufacturer (Section D) |
| AESCULAP AG |
| po box 40 |
| tuttlingen, 78501 |
| GM 78501 |
|
| MDR Report Key | 25431192 |
| Report Number | 3005673311-2026-00098 |
| Device Sequence Number | 10310094 |
| Product Code |
JWH
|
| UDI-Device Identifier | 04046963810399 |
| UDI-Public | (01)04046963810399(11)171006(17)270930(10)52374229 |
| Combination Product (Y/N) | N |
| Initial Reporter State | CA |
| Initial Reporter Country | US |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2018 |
| Device Explanted Year | 2023 |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Importer
|
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
07/02/2026 |
| Report Date (Section F) |
06/08/2026 |
| 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 | NX052Z |
| Device Catalogue Number | NX052Z |
| Device Lot Number | 52374229 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Was the Report Sent to FDA? |
Yes
|
| Distributor Facility Aware Date | 05/14/2026 |
| Device Age | 68 MO |
| Event Location |
Hospital
|
| Date Report to Manufacturer | 05/14/2026 |
| 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 | 06/08/2026 |
| Supplement Report FDA Received Date | 07/02/2026
|
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 | 70 YR |
| Patient Sex | Unknown |
| Patient Weight | 104 KG |
| Date Report Sent to FDA | 06/08/2026 |
|
|