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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. LOCK SCREW SQ 2.7MM 16MM STE; PROSTHESIS TRAUMA

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ZIMMER BIOMET, INC. LOCK SCREW SQ 2.7MM 16MM STE; PROSTHESIS TRAUMA Back to Search Results
Model Number N/A
Medical Device Problem Code Device Contaminated During Manufacture or Shipping (2969)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/11/2021
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Report source: (b)(6).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.Multiple mdr reports were filed for this event, please see associated reports: 001825034-2021-03023, 0001825034-2021-03024, 0001825034-2021-03025, 0001825034-2021-03026, 0001825034-2021-03027.Not returned.
 
Event or Problem Description
It was reported upon inspection that there was debris in the sterile package.
 
Event or Problem Description
No further event information available at the time of this report.
 
Additional Manufacturer Narrative
(b)(4) reported event was not confirmed as visual examination of the returned product found no evidence of debris.As the products were determined to be acceptable as no debris was found as reported, a limited investigation process was followed.No product failure was found as the products are within specifications.No further investigation or action is required after review.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
LOCK SCREW SQ 2.7MM 16MM STE
Common Device Name
PROSTHESIS TRAUMA
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
Manufacturer (Section G)
ZIMMER BIOMET, INC.
56 e. bell drive
warsaw IN 46582
Manufacturer Contact
christina arnt
56 e. bell dr.
warsaw, IN 46582
5745273773
MDR Report Key12738803
Report Number0001825034-2021-03028
Device Sequence Number4560023
Product Code HRS
UDI-Device Identifier00887868450280
UDI-Public(01)00887868450280(17)310223(10)974000
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K173767
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Company Representative,Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 01/12/2022
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 Number131827116
Device Lot Number974000
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/03/2021
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/11/2021
Supplement Date Received by Manufacturer12/30/2021
Initial Report FDA Received Date11/02/2021
Supplement Report FDA Received Date01/13/2022
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/23/2021
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
N/A
Patient Sequence Number1
Patient SexUnknown
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