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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. VANGUARD DISTAL FEMORAL PEG SET 2; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. VANGUARD DISTAL FEMORAL PEG SET 2; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Device Problem Tear, Rip or Hole in Device Packaging (2385)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/10/2023
Event Type  malfunction  
Event Description
It was reported that during a knee arthroplasty when the packaging for the femoral pegs was opened, the inner sterile bags were identified to be torn.The pegs were not used in the procedure.No adverse events were reported as a result of this malfunction.
 
Manufacturer Narrative
(b)(4).Concomitant devices - vanguard distal femoral peg set 2 catalog #: 183099 lot #: 368910.Report source - foreign: event occurred in japan.The product has been received by zimmer biomet and the investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.Multiple mdr reports were filed for this event; please see all reports associated with this event: 0001825034-2023-00958.
 
Event Description
No further event information available at the time of this report.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections were updated: b4, g3, g6, h2, h3, h6, h10.Visual evaluation of the returned devices identified that the inner sterile pouches were broken into multiple pieces.However, evaluation of the outer pouches found no damage, and therefore sterility was not breached.The device history records were reviewed and no discrepancies were identified.As the condition of the devices was conforming when it left zimmer biomet, a definitive root cause could not be determined with the information provided.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
VANGUARD DISTAL FEMORAL PEG SET 2
Type of Device
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer (Section G)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key16873710
MDR Text Key314638173
Report Number0001825034-2023-00957
Device Sequence Number1
Product Code MBH
UDI-Device Identifier00880304447646
UDI-Public(01)00880304447646(17)260826(10)368860
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K113550
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 06/12/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/04/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue Number183099
Device Lot Number368860
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/27/2023
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received06/05/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured08/26/2016
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
Patient SexPrefer Not To Disclose
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