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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TL 133 MP SP 12/14 BM HO 5.0; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. TL 133 MP SP 12/14 BM HO 5.0; PROSTHESIS, HIP 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 03/31/2023
Event Type  malfunction  
Manufacturer Narrative
(b)(4).G2: report source italy.Product will not be returned to zimmer biomet for the investigation as the product location is unknown.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event Description
It was reported that during a hip procedure, upon opening the package of a femoral hip stem, it was found that the stem had punctured through the sterile packaging.A new product was used to complete the surgery.There was no direct contact with the patient.Attempts have been made and additional information on the reported event is unavailable at this time.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Visual evaluation of the provided photo identified damage to the sterile packaging (blister and pouch).Sterility has been compromised.The reported event has been confirmed by review of the provided photo.Review of the device history records identified no deviations or anomalies during manufacturing related to the reported event.The condition of the device when it left zimmer biomet is conforming to specification.The root cause of the reported event can be attributed to transit damage and a packaging design issue.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.
 
Event Description
No additional event information to report at this time.
 
Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Visual examination of the returned product confirmed damage to the sterile packaging and sterility is compromised.Return of the product does not alter the previous investigation as the root cause remains attributed to transit damage and a packaging design issue.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.
 
Event Description
No additional information.
 
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Brand Name
TL 133 MP SP 12/14 BM HO 5.0
Type of Device
PROSTHESIS, HIP
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 Key16713279
MDR Text Key313110488
Report Number0001825034-2023-00783
Device Sequence Number1
Product Code KWA
UDI-Device Identifier00880304512597
UDI-Public(01)00880304512597(17)280818(10)6364660
Combination Product (y/n)N
Reporter Country CodeIT
PMA/PMN Number
K101086
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Nurse
Type of Report Initial,Followup,Followup
Report Date 08/02/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberN/A
Device Catalogue Number51-139050
Device Lot Number6364660
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 04/02/2023
Initial Date FDA Received04/11/2023
Supplement Dates Manufacturer Received05/25/2023
07/20/2023
Supplement Dates FDA Received06/13/2023
08/02/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured08/18/2018
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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