inforMED
InjuryISH

VARI-FLEX MODULAR

Received May 8, 2014 · Event occurred Apr 2, 2014

Report 3003764610-2014-00002 · MDR key 3815616

Device

Generic name

Component, External, Limb, Ankle/foot

Manufacturer

Ossur

Model number

P20194

Catalog number

P20194

Product problems

  • Component Falling
  • Device Slipped

Patient

Not reported

  • Fall
  • Loss of consciousness

Narrative

Description of Event or Problem

BELOW KNEE AMPUTEE PATIENT WAS WALKING WHEN THE PROSTHESIS BECAME UNLOCKED. THE LEG FELL OFF CAUSING HER TO FALL INTO A RETAINING WALL. SHE WAS KNOCKED UNCONSCIOUS.

Additional Manufacturer Narrative

CONCLUSION: WE NEED THIS ICELOCK 400 TO PERFORM FURTHER INVESTIGATION FOR THE ROOT CAUSE FOR THIS INCIDENT. WHEN RECEIVED THIS RA FORM 219 WILL BE UPDATED. IN PROJECT (B)(4) THE SURFACE TREATMENT OF BOTH LOCKING WASHER AND THE PIN WAS CHANGED TO PREVENT THIS TO HAPPEN. ALSO IT IS VERY IMPORTANT TO CHANGE THE LOCKING PIN AS RECOMMENDED IN IFU A LEAST YEARLY.