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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TPRLC 133 MP TYPE1 PPS SO 14.0; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. TPRLC 133 MP TYPE1 PPS SO 14.0; 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 12/22/2021
Type of Reportable Event Malfunction
Additional 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.Multiple mdr reports were filed for this event, please see associated reports:  0001825034-2022-00023.
 
Event or Problem Description
It was reported there was an issue with the sterile packaging being damaged.Attempts have been made and additional information on the reported event is unavailable at this time.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Visual evaluation of the returned product found creasing in the sterile pouch.No holes, punctures, or tears were noted.Dhr was reviewed and no discrepancies were found.The condition when the product 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 or Problem Description
No additional event information to report at this time.
 
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Brand Name
TPRLC 133 MP TYPE1 PPS SO 14.0
Common Device Name
PROSTHESIS, HIP
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 Key13177700
Report Number0001825034-2022-00024
Device Sequence Number19999870
Product Code KWA
UDI-Device Identifier00880304514355
UDI-Public00880304514355
Combination Product (Y/N)N
Initial Reporter StateAL
Initial Reporter CountryUS
PMA/510(K) Number
K110400
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Distributor
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 03/07/2022
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 Number51-106140
Device Lot Number6974850
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/17/2022
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/22/2021
Supplement Date Received by Manufacturer03/04/2022
Initial Report FDA Received Date01/06/2022
Supplement Report FDA Received Date03/08/2022
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/05/2021
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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