MAUDE Adverse Event Report: Medacta International SA GMK Primary Total Knee System; GMK Tibial Tray Cemented Right S4

Model Number	02.07.1204R
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code	Medical device site infection (4845)
Date of Event	07/15/2026
Type of Reportable Event	Serious Injury
Event or Problem Description
Revision surgery after 5 months from the primary due to infection.The surgeon revised all the components to match those of the competitor.
Additional Manufacturer Narrative
Batch review performed on 23 july 2026 02.07.1204r gmk tibial tray cemented right s4 (k090988) lot.2517450: (b)(4) items manufactured and released on 29 september 2025.Expiration date: 12 september 2030.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.02.12.E0410fr gmk-sphere tibial insert e-cross - flex 4r - 10mm (k202022) lot.2520130: (b)(4) items manufactured and released on 29 august 2025.Expiration date: 31 july 2030.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.02.12.Ka14r gmk spherika femoral component s4+r cemented (k211004) lot.2518172: (b)(4) items manufactured and released on 19 september 2025.Expiration date: 07 september 2030.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.

• Brand Name: GMK Primary Total Knee System
• Common Device Name: GMK Tibial Tray Cemented Right S4
• 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: 50005872
• Report Number: 3005180920-2026-00779
• Device Sequence Number: 10457231
• Product Code: JWH
• UDI-Device Identifier: 07630030819919
• UDI-Public: 07630030819919
• Combination Product (Y/N): N
• PMA/510(K) Number: K090988
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2026
• Device Explanted Year: 2026
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Type of Report: Initial
• Report Date (Section B): 07/23/2026

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: 02.07.1204R
• Device Lot Number: 2517450
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 07/15/2026
• Initial Report FDA Received Date: 07/27/2026
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 09/29/2025
• 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: Female
• Patient Race: White