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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. VNGD SSK PSC TIB BRG 22X71/75; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. VNGD SSK PSC TIB BRG 22X71/75; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Medical Device Problem Code Tear, Rip or Hole in Device Packaging (2385)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/17/2022
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Product has been received by zimmer biomet and the investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event or Problem Description
It was reported that during a knee procedure, the tibial bearing sterile packaging was found to have a hole in it.Attempts to obtain additional information have been made; however, no more is available.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Updated: b4, g3, g6, h2, h3, h6, and h10.Complaint sample was evaluated and the reported event was confirmed.Visual evaluation of the returned product identified a puncture to the sterile packaging (inner and outer tyvek lids).Sterility has been compromised.Device history record was reviewed and no discrepancies relevant to the reported event were found.The likely 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.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 further event information available at the time of this report.
 
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Brand Name
VNGD SSK PSC TIB BRG 22X71/75
Common Device Name
PROSTHESIS, KNEE
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 Key14075431
Report Number0001825034-2022-00846
Device Sequence Number2571870
Product Code JWH
UDI-Device Identifier00880304440869
UDI-Public(01)00880304440869(17)230905(10)122800
Combination Product (Y/N)N
Initial Reporter StateIN
Initial Reporter CountryUS
PMA/510(K) Number
K171054
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) 05/31/2022
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 Expiration Date09/05/2023
Device Model NumberN/A
Device Catalogue Number183892
Device Lot Number122800
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/30/2022
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 03/17/2022
Supplement Date Received by Manufacturer05/12/2022
Initial Report FDA Received Date04/11/2022
Supplement Report FDA Received Date05/31/2022
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/05/2018
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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