MAUDE Adverse Event Report: MEDACTA INTERNATIONAL SA GMK-SPHERIKA TIBIAL INSERT FIXED SPHERE FLEX SIZE 3/11 MM L E-CROSS; KNEE TIBIAL INSERT

Catalog Number 02.12.E0311FL

Device Problem Device Appears to Trigger Rejection (1524)

Event Date 03/12/2024

Event Type  Injury  

Manufacturer Narrative

Batch review performed on 18-mar-2024.Lot 2308746: (b)(4) items manufactured and released on 22-may-2023.Expiration date: 2028-05-01.No anomalies found related to the problem.To date, (b)(4) items of the same lot have been sold with no similar reported event during the period of review.

Event Description

At 1 month from the primary, the patient came in due to signs of an infection and the pathogen is unknown.The surgeon performed a washout and revised the head and liner.The surgery was completed successfully.

• Brand Name: GMK-SPHERIKA TIBIAL INSERT FIXED SPHERE FLEX SIZE 3/11 MM L E-CROSS
• Type of Device: KNEE TIBIAL INSERT
• Manufacturer (Section D): MEDACTA INTERNATIONAL SA; strada regina; castel san pietro, switzerland 6874 ; SZ 6874
• Manufacturer (Section G): MEDACTA INTERNATIONAL SA; strada regina; castel san pietro, switzerland 6874 ; SZ 6874
• Manufacturer Contact: marco giannessi ; strada regina; castel san pietro, switzerland 6874 ; SZ 6874
• MDR Report Key: 19069666
• MDR Text Key: 339678388
• Report Number: 3005180920-2024-00193
• Device Sequence Number: 1
• Product Code: JWH
• UDI-Device Identifier: 07630971261556
• UDI-Public: 07630971261556
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K112115
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Other
• Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• Report Date: 04/09/2024

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?: No
• Device Operator: Health Professional
• Device Catalogue Number: 02.12.E0311FL
• Device Lot Number: 2308746
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 03/12/2024
• Initial Date FDA Received: 04/09/2024
• Was Device Evaluated by Manufacturer?: No
• Date Device Manufactured: 11/22/2023
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention