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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. 36MM I.D. SIZE E HIGH WALL LINER; PROTHESIS, HIP

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ZIMMER BIOMET, INC. 36MM I.D. SIZE E HIGH WALL LINER; PROTHESIS, HIP Back to Search Results
Model Number N/A
Device Problem Device Contaminated During Manufacture or Shipping (2969)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 03/15/2023
Event Type  malfunction  
Manufacturer Narrative
(b)(4).Customer has indicated that the product is in process of being returned to zimmer biomet for investigation.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event Description
It was reported there was hair stuck on the implant.The circulator opened the implant and had it available for the scrub nurse to take.The scrub nurse noticed the hair on the cup of the liner.The scrub nurse refused to take the implant.The packaging was intact before opening.There was no consequences or impact to the patient.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional and/or corrected information.No product was returned; visual and dimensional evaluations could not be performed.Visual evaluation of the provided photos found a hair-like fiber on the device.The packaging has been previously opened; therefore, the origin of the fiber cannot be determined.This complaint cannot be confirmed as the product was previously opened.Review of the device history records identified no related deviations or anomalies during manufacturing related to the reported event.Review of complaint history found no additional related issues for the reported part and lot combination.Medical records were not provided.A definitive root cause cannot be determined.If any further information is found which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
Event Description
No additional event information to report at this time.
 
Event Description
No further information is available at the time of this report.
 
Manufacturer Narrative
(b)(4).This follow-up report is being submitted to relay additional information.The following sections were updated/corrected: updated: d9; g3; h2; h6.Visual evaluation of the returned product found a hair-like debris.The sterile packaging was previously opened.This complaint has been confirmed by evaluation of the returned product.Return of the product does not alter the previous investigation.A definitive root cause or condition of the device when it left zimmer biomet cannot be determined, as the product was returned opened.If any further information is found which would change or alter any conclusions or information, a supplemental will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
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Brand Name
36MM I.D. SIZE E HIGH WALL LINER
Type of Device
PROTHESIS, HIP
Manufacturer (Section D)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer (Section G)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key16691276
MDR Text Key312805635
Report Number0001822565-2023-00946
Device Sequence Number1
Product Code LPH
UDI-Device Identifier00889024520486
UDI-Public(01)00889024520486(17)271009(10)65604132
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K190660
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Distributor
Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date 10/05/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/06/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue Number30123605
Device Lot Number65604132
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received10/02/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured10/10/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Removal/Correction NumberN/A
Patient Sequence Number1
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