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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 1; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. TPRLC 133 MP TYPE1 PPS SO 14.0 1; 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 02/07/2022
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Foreign: country: (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: 0001825034 - 2022 - 00485, 0001825034 - 2022 - 00487, 0001825034 - 2022 - 00489, 0001825034 - 2022 - 00490.
 
Event or Problem Description
It was reported circulated items were inspected and identified the sterile package was damaged.No patient involvement.No additional information.
 
Event or Problem Description
Upon reassessment of the reported event, it has been determined that the device sterility has not been compromised.The initial report was forwarded in error and should be voided.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections were updated/corrected updated: b4, b5, g3, h2, h3, h6 upon reassessment of the reported event, it has been determined that the device sterility has not been compromised.The initial report was forwarded in error and should be voided.
 
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Brand Name
TPRLC 133 MP TYPE1 PPS SO 14.0 1
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 Key13685179
Report Number0001825034-2022-00488
Device Sequence Number11248500
Product Code KWA
UDI-Device Identifier00880304514355
UDI-Public(01)00880304514355(17)290723(10)6594544
Combination Product (Y/N)N
Initial Reporter CountryJA
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 Foreign,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 04/20/2022
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 Number6594544
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/07/2022
Supplement Date Received by Manufacturer04/14/2022
Initial Report FDA Received Date03/07/2022
Supplement Report FDA Received Date04/20/2022
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/23/2019
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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