FDA Adverse Event Injury Summary report: N

SMS STEM

MDR report key: 24004377 · Received January 8, 2026

Report

Report Number
3005180920-2026-00022
Event Type
Injury
Date Received
January 8, 2026
Date of Event
December 23, 2025
Report Date
January 8, 2026
Manufacturer
MEDACTA INTERNATIONAL SA
Product Code
LZO
UDI-DI
07630345701749
PMA / PMN Number
K203041
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

BATCH REVIEW PERFORMED ON 29 DECEMBER 2025. STEM: SMS SOLID COLLARED 01.36.147 SMS COLLARED SOLID STEM STD SIZE 7 (K203041) LOT 2244073: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 22-MAR-2023. EXPIRATION DATE: 05-MAR-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. ROOT CAUSE: ASEPTIC LOOSENING IS A POSSIBLE LITERATURE-DESCRIBED ADVERSE EVENT AFTER PRIMARY JOINT ARTHROPLASTIES AND CAUSES ARE OFTEN UNKNOWN. THERE IS NO INDICATION THAT ANY POTENTIAL ISSUE WITH THE DEVICE MAY HAVE CAUSED OR CONTRIBUTED TO THE EVENT. NO PREVIOUS CASE HAS BEEN ADDRESSED TO A DEVICE DESIGN OR MANUFACTURING RELATED ROOT CAUSE.

Description of Event or Problem · 0

AT ABOUT 1 YEAR 6 MONTHS FROM THE PRIMARY, THE PATIENT CAME IN REPORTING PAIN DUE TO A LOOSE STEM AND THE CAUSE IS UNKNOWN. THE SURGEON REVISED THE STEM, HEAD AND LINER. THE SURGERY WAS COMPLETED SUCCESSFULLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
67351 SMS STEM SMS COLLARED SOLID STEM STD SIZE7 LZO MEDACTA INTERNATIONAL SA 01.36.147 2244073 07630345701749

Patients

Seq Age Sex Outcome Treatment
1 NA Female Required Intervention