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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITH & NEPHEW, INC. JRN II BCS LCK FEM IMPLANT IMPACT; PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL

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SMITH & NEPHEW, INC. JRN II BCS LCK FEM IMPLANT IMPACT; PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL Back to Search Results
Catalog Number 74012812
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/28/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that, during a tka surgery, plastic tip of one (1) jrn ii bcs lck fem implant impact broke off.The procedure was resumed, without any delay, using an equivalent s+n back-up.No further complications were reported.
 
Additional Manufacturer Narrative
Internal complaint reference: (b)(4).
 
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Brand Name
JRN II BCS LCK FEM IMPLANT IMPACT
Common Device Name
PROSTHESIS, KNEE, PATELLOFEMOROTIBIAL, SEMI-CONSTRAINED, CEMENTED, POLYMER/METAL
Manufacturer (Section D)
SMITH & NEPHEW, INC.
1450 brooks rd.
memphis TN 38116
Manufacturer (Section G)
SMITH & NEPHEW, INC.
1450 brooks rd.
memphis TN 38116
Manufacturer Contact
holly topping
1450 brooks rd.
memphis, TN 38116
5123913905
MDR Report Key25342923
Report Number1020279-2026-00729
Device Sequence Number12038522
Product Code JWH
UDI-Device Identifier00885556003541
UDI-Public885556003541
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
K111711
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Literature,Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 07/08/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Catalogue Number74012812
Device Lot Number22LSM0297
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/19/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/07/2026
Supplement Date Received by Manufacturer06/12/2026
Initial Report FDA Received Date05/31/2026
Supplement Report FDA Received Date07/08/2026
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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