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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. E1 VNGD CR TIB BRG 71/75X12 X 12; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. E1 VNGD CR TIB BRG 71/75X12 X 12; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Medical Device Problem Code Manufacturing, Packaging or Shipping Problem (2975)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported a hair was found in the in the sterile packaging.The incident occurred intraoperatively, however no adverse events have been reported as a result of this malfunction.Attempts have been made and additional information on the reported event is unavailable at this time.
 
Additional Manufacturer Narrative
(b)(4).Foreign country: (b)(6).Customer has indicated that the product will not be returned to zimmer biomet for investigation, due to the location of the device is unknown.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Visual and dimensional evaluations of the product could not be performed as no product was returned nor were pictures provided.Device history record was reviewed and no discrepancies related to the reported event were found.Root cause was unable to be determined.If any further information is found which would change or alter any conclusions or information, a supplemental report will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
Event or Problem Description
No further event information at time of this report.
 
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Brand Name
E1 VNGD CR TIB BRG 71/75X12 X 12
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 Key14094611
Report Number0001825034-2022-00885
Device Sequence Number14585013
Product Code JWH
UDI-Device Identifier00880304466142
UDI-Public(01)00880304466142(17)261028(10)740310
Combination Product (Y/N)N
Initial Reporter CountryGM
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 Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 08/23/2022
2 Devices were Involved in the Event: 1   2  
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 NumberEP-183442
Device Lot Number740310
Was Device Available for Evaluation? No
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 03/31/2022
Supplement Date Received by Manufacturer08/10/2022
Initial Report FDA Received Date04/13/2022
Supplement Report FDA Received Date08/25/2022
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured10/28/2021
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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