MAUDE Adverse Event Report: Medacta International SA GMK Primary Total Knee System; Tibial tray fix cemented S.4L

Model Number	02.07.1204L
Medical Device Problem Code	Device Appears to Trigger Rejection (1524)
Health Effect - Clinical Code	Medical device site infection (4845)
Date of Event	08/05/2026
Type of Reportable Event	Serious Injury
Event or Problem Description
At about 1 year and 9 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 gmk-sphere cemented s4 tibial tray to a rev.Tibial tray left s4 and revised the flex 4l - 11mm insert to a flex 4l - 13mm at his discretion.The surgery was completed successfully.
Additional Manufacturer Narrative
Batch review performed on 06 august 2026 gmk-sphere 02.07.1204l tibial tray fix cemented s.4l () lot 2348228: (b)(4) items manufactured and released on 02-may-2024.Expiration date: 15-apr-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.Gmk-sphere 02.12.E0411fl gmk-sphere tibial insert e-cross - flex 4l - 11mm () lot 2116927: (b)(4) items manufactured and released on 12-may-2022.Expiration date: 19-dec-2026.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: Tibial tray fix cemented S.4L
• 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: 50209598
• Report Number: 3005180920-2026-00858
• Device Sequence Number: 17672694
• Product Code: JWH
• UDI-Device Identifier: 07630030819902
• UDI-Public: 07630030819902
• Combination Product (Y/N): N
• PMA/510(K) Number: K090988
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2024
• 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): 08/11/2026

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: 02.07.1204L
• Device Lot Number: 2348228
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 08/05/2026
• Initial Report FDA Received Date: 08/11/2026
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 05/02/2024
• 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 Age: 87 YR
• Patient Sex: Male
• Patient Race: White