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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: WALDEMAR LINK GMBH & CO. KG ENDO-MODEL® ROTATIONAL KNEE PROSTHESIS ROTATING HINGED TOTAL KNEE PROSTHESIS

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WALDEMAR LINK GMBH & CO. KG ENDO-MODEL® ROTATIONAL KNEE PROSTHESIS ROTATING HINGED TOTAL KNEE PROSTHESIS Back to Search Results
Model Number 15-2815/12
Device Problem Naturally Worn (2988)
Patient Problem Failure of Implant (1924)
Event Date 06/14/2016
Event Type  Injury  
Manufacturer Narrative
All product features corresponded with the valid specifications of the waldemar link at the time, when the item was produced. The batch documentation review incl. The quality inspection reports did not reveal irregulations or deviations in the production process. The implant corresponds with our specifications. The visual inspection shows the uhmwpe bushing is worn. The customer was contacted several times for further information regarding this incident. As the xray images and surgery reports were not provided, we have not been able to conduct a more comprehensive investigation to determine the root cause in this case. It is assumed that functional overload is the cause for this issue. The waldemar link is aiming for the highest product quality and trying to keep the failure rate as low as possible by means of the customer feedback. Permanent employee trainings and market surveillance are performed. The report is delayed due to inconsistencies with regard to foreign event reporting to fda. After re-evaluation of the complaint we determined that it is reportable. We have addressed the inconsistency in reporting foreign events to fda through capa (b)(4).
 
Event Description
Translation: instability and pain, damage of the rotational bushing.
 
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Brand NameENDO-MODEL® ROTATIONAL KNEE PROSTHESIS
Type of DeviceROTATING HINGED TOTAL KNEE PROSTHESIS
Manufacturer (Section D)
WALDEMAR LINK GMBH & CO. KG
barkhausenweg 10
hamburg, 22339
GM 22339
Manufacturer (Section G)
WALDEMAR LINK GMBH & CO. KG
barkhausenweg 10
hamburg, 22339
GM 22339
Manufacturer Contact
annerike kleine
barkhausenweg 10
hamburg, 
GM  
MDR Report Key8296493
MDR Text Key134712948
Report Number3004371426-2019-00041
Device Sequence Number1
Product Code KRO
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
K143179
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type foreign
Reporter Occupation
Type of Report Initial
Report Date 07/07/2016
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/01/2019
Is this an Adverse Event Report? Yes
Device Operator
Device Expiration Date04/30/2017
Device Model Number15-2815/12
Device Catalogue Number15-2815/12
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/15/2016
Is the Reporter a Health Professional?
Was the Report Sent to FDA?
Event Location No Information
Date Manufacturer Received07/07/2016
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured04/01/2012
Is the Device Single Use? No Answer Provided
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial

Patient Treatment Data
Date Received: 02/01/2019 Patient Sequence Number: 1
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