MAUDE Adverse Event Report: MEDACTA INTERNATIONAL SA SMS STEM; SMS SOLID STEM STD SIZE8

Model Number	01.36.048
Medical Device Problem Code	Device Appears to Trigger Rejection (1524)
Health Effect - Clinical Code	Medical device site infection (4845)
Date of Event	04/21/2026
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
Batch review performed on 28 arpil 2026 stem: sms solid 01.36.048 sms solid stem std size 8 (k181693) lot 2248976: (b)(4) items manufactured and released on 27-apr-2023.Expiration date: 05-apr-2028.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.Ball heads: mectacer 01.29.203 mectacer head biolox delta dia.28 12/14-l (k112115) lot 2425507: (b)(4) items manufactured and released on 25-sep-2024.Expiration date: 11-sep-2029.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.Liner: mpact dm 01.32.152mb mpact dm acetabular shell d 52 (k143453) lot 2417831: (b)(4) items manufactured and released on 11-dec-2024.Expiration date: 20-nov-2029.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.Root cause:infection is a known possible complication of any surgery.Although no root cause can be established, there is no indication that any issue with the device may have caused or contributed to the event, and the document review does not indicate any potential manufacturing related cause.
Event or Problem Description
At about 11 months from the primary, the patient came in due to signs of infection and the pathogen is unknown.The surgeon performed a washout and revised the sms solid stem size8 to an amistem-c size3, revised the 28mm biolox head l to a 40mm biolox head xl, and revised the d 28/dmf double mobility liner to a face changing 10° hc liner d 40/g.The surgery was completed successfully.

• Brand Name: SMS STEM
• Common Device Name: SMS SOLID STEM STD SIZE8
• Manufacturer (Section D): MEDACTA INTERNATIONAL SA; strada regina; castel san pietro 6874 ; SZ 6874
• Manufacturer Contact: marco giannessi ; strada regina; castel san pietro 6874 ; SZ 6874
• MDR Report Key: 25148979
• Report Number: 3005180920-2026-00433
• Device Sequence Number: 10745143
• Product Code: LZO
• UDI-Device Identifier: 07630030888670
• UDI-Public: 07630030888670
• Combination Product (Y/N): N
• PMA/510(K) Number: K181693
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2025
• Device Explanted Year: 2026
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 05/12/2026

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?: No
• Operator of Device: Health Professional
• Device Model Number: 01.36.048
• Device Lot Number: 2248976
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 04/21/2026
• Initial Report FDA Received Date: 05/12/2026
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 04/27/2023
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Sex: Unknown