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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TPRLC 133 T1 PPS SO 13X146MMTP; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. TPRLC 133 T1 PPS SO 13X146MMTP; PROSTHESIS, HIP Back to Search Results
Model Number N/A
Medical Device Problem Code Packaging Problem (3007)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/12/2021
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Foreign country: (b)(6).Multiple reports were reported along with this report 0001825034-2021-01341, 0001825034 -2021-01342, 0001825034-2021-01343, 0001825034-2021-01349.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 or Problem Description
It was reported that the sterile package was damaged.No adverse events have been reported as a result of the malfunction and additional information on the reported event is unavailable at this time.
 
Event or Problem Description
No further event information available at the time of this report.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Evaluation of the returned products confirmed damage to the sterile packaging blister, and there is debris inside the sterile packaging which is consistent with the appearance of porous coating, and foam debris from the foam packaging inside the sterile barrier.Sterility has not been compromised.The reported event is confirmed complaint sample was evaluated and the reported event was confirmed.Review of the device history records identified no deviations or anomalies during manufacturing related to the reported event.The likely condition of the products when they left zimmer biomet was conforming to specifications.The root cause of the reported event is likely due to transit damage.As part of a corrective action, the sterile packaging configuration is moving to a double blister configuration.Upon investigation, it has been determined that the debris in the sterile packaging meets the acceptable criteria and product is conforming to specifications.Event is no longer considered reportable, and initial report should be voided 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
TPRLC 133 T1 PPS SO 13X146MMTP
Common Device Name
PROSTHESIS, HIP
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
MDR Report Key11770160
Report Number0001825034-2021-01347
Device Sequence Number3104573
Product Code JDI
UDI-Device Identifier00880304517318
UDI-Public(01)00880304517318(17)260410(10)6273986
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K120030
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source company representative,distri
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 06/04/2021
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
Operator of Device Health Professional
Device Model NumberN/A
Device Catalogue Number51-103130
Device Lot Number6273986
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/20/2021
Was the Report Sent to FDA? No
Initial Date Received by Manufacturer 04/12/2021
Supplement Date Received by Manufacturer05/28/2021
Initial Report FDA Received Date05/04/2021
Supplement Report FDA Received Date06/04/2021
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
N/A
Patient Sequence Number1
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