FDA Adverse Event Injury Summary report: N

MECTACER BIOLOX DELTA FEMORAL BALL HEAD

MDR report key: 24208596 · Received January 29, 2026

Report

Report Number
3005180920-2026-00055
Event Type
Injury
Date Received
January 29, 2026
Date of Event
January 13, 2026
Report Date
January 29, 2026
Manufacturer
MEDACTA INTERNATIONAL SA
Product Code
LZO
UDI-DI
07630030809149
PMA / PMN Number
K112115
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

BATCH REVIEW PERFORMED ON 15 JANUARY 2026. BALL HEADS: MECTACER 01.29.203 MECTACER HEAD BIOLOX DELTA DIA.28 12/14-L (K112115) LOT 2515046: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 18-JUN-2025. EXPIRATION DATE: 04-JUN-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. LINER: VERSAFITCUP DM 01.26.2854MHC DOUBLE MOBILITY HC LINER D 28/DMG (K09226) LOT 2523294: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 09-OCT-2025. EXPIRATION DATE: 21-SEP-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. STEM: AMISTEM P 01.18.411 AMISTEM-P LAT STEM SIZE1 (K173794) LOT 1908458C: (B)(4) ITEMS MANUFACTURED AND RELEASED ON 03-FEB-2025. EXPIRATION DATE: 19-JAN-2030. NO ANOMALIES FOUND RELATED TO THE PROBLEM. TO DATE, (B)(4) ITEM OF THE SAME LOT HAS BEEN SOLD WITH NO SIMILAR REPORTED EVENT DURING THE PERIOD OF REVIEW. CUP: VERSAFITCUP 01.26.54MB VERSAFITCUP METALBACK DM D 54 MM (K083116) LOT 2515046: 100 ITEMS MANUFACTURED AND RELEASED ON 18-JUN-2025. EXPIRATION DATE: 04-JUN-2030. NO ANOMALIES FOUND RELATED TO THE PROBLEM. TO DATE, 80 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.

Description of Event or Problem · 0

REVISION SURGERY DUE TO INFECTION ABOUT 1 MONTH AND A HALF AFTER THE PRIMARY SURGERY. ALL COMPONENTS REVISED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
277067 MECTACER BIOLOX DELTA FEMORAL BALL HEAD MECTACER HEAD BIOLOX DELTA DIA.28 12/14-L LZO MEDACTA INTERNATIONAL SA 01.29.203 2515046 07630030809149

Patients

Seq Age Sex Outcome Treatment
1 55 YR Male Required Intervention