FDA Adverse Event Injury Summary report: N

GMK SPHERE TOTAL KNEE SYSTEM

MDR report key: 21261901 · Received January 29, 2025

Report

Report Number
3005180920-2025-00007
Event Type
Injury
Date Received
January 29, 2025
Date of Event
January 2, 2025
Report Date
January 29, 2025
Manufacturer
MEDACTA INTERNATIONAL SA
Product Code
JWH
UDI-DI
07630971261327
PMA / PMN Number
K202022
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

BATCH REVIEW PERFORMED ON 08 JANUARY 2025. LOT 2012373: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 18-FEB-2021. EXPIRATION DATE: 2026-01-27. NO ANOMALIES FOUND RELATED TO THE PROBLEM. TO DATE, (B)(4) ITEMS OF THE SAME LOT HAVE BEEN SOLD WITH NO SIMILAR REPORTED EVENTS DURING THE PERIOD OF REVIEW. 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.

Description of Event or Problem · 0

AT ABOUT 10 DAYS AFTER 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 LINER. THE SURGERY WAS COMPLETED SUCCESSFULLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1818985 GMK SPHERE TOTAL KNEE SYSTEM TIBIAL INSERT FIXED SPHERE FLEX SIZE 2/11 MM R E-CROSS JWH MEDACTA INTERNATIONAL SA 02.12.E0211FR 2012373 07630971261327

Patients

Seq Age Sex Outcome Treatment
1 80 YR Female Required Intervention