Smith+Nephew said on October 23 that talks to merge its orthopedics business with Johnson & Johnson's have stopped. The Financial Times reported the breakdown first. The sticking point was leadership. Smith+Nephew opposed installing Namal Nawana, J&J's former orthopedics chief, atop the combined company.

The structure under discussion left J&J shareholders with 50.1 percent. Smith+Nephew planned a $10 billion dividend to J&J to bridge the valuation gap. Smith+Nephew's market capitalization sits near $12.7 billion. The two sides had been aiming to announce in mid-October.

J&J said earlier this month it wants DePuy Synthes separated by mid-2027. That separation now goes ahead on its own. For the contract manufacturers and instrument suppliers who were modeling one consolidated ortho customer, the account list stays as it is.