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ENCORE MEDICAL, L.P. 3DKNEE; INSERT, 3D EX SZ 6RT 11MM Back to Search Results
Model Number 392-11-706
Device Problem Device Dislodged or Dislocated (2923)
Patient Problem Joint Dislocation (2374)
Event Date 05/02/2017
Event Type  Injury  
Event Description
Revision surgery - due to the patient's knee having dislocated; the surgeon removed and replaced the original insert.
Manufacturer Narrative
The reason for this revision surgery was the patient's knee dislocated.The previous surgery and the revision detailed in this investigation occurred over 1 year and 1 month apart.The healthcare professional indicated there was no delay in surgery and another suitable device was available for use.The revision surgery was completed as intended.The device was disposed of at the hospital and not made available to djo surgical for examination.A review of the implant device history records (dhr) shows that the reported component used in the previous surgery met design and manufacturing requirements.There were no non-conforming material reports (ncmrs) associated with the product that may have contributed to the event.The device was within its expiration date at the time of use during the previous surgery.Customer complaint history of the reported device showed no present trends or on-going issues that are in need of review.The root cause of this complaint was a revision surgery due to the dislocation.There were no findings during this investigation that indicate that the reported device was the source or had a direct connection with the patient's dislocation.There are multiple factors that may contribute to the event that are outside the control of djo surgical are patient activities, inadequate soft tissue, excessive range-of-motion, excessive load or trauma.No additional information was submitted with the complaint regarding pre-existing conditions of the patient or any activities that may have contributed to the event and hence a definitive root cause cannot be determined.Inventory containment is not required as there are no indications of a product or process issue affecting implant safety or effectiveness.
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Brand Name
Type of Device
Manufacturer (Section D)
9800 metric blvd.
austin TX 78758 5445
Manufacturer (Section G)
9800 metric blvd.
austin TX 78758 5445
Manufacturer Contact
teffany hutto
9800 metric blvd.
austin, TX 78758-5445
MDR Report Key6603334
MDR Text Key76371250
Report Number1644408-2017-00413
Device Sequence Number1
Product Code OIY
UDI-Device Identifier00888912120531
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 07/20/2017
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/31/2017
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Expiration Date12/31/2018
Device Model Number392-11-706
Device Catalogue Number392-11-706
Device Lot Number59604334
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Date Manufacturer Received06/21/2017
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured01/08/2014
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age79 YR