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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 12X144MM; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 12X144MM; PROSTHESIS, HIP 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 04/18/2022
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).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.
 
Event or Problem Description
It was reported sterile packaging was found damaged while inspecting items in stock.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.Reported event has been confirmed.Visual evaluation of the returned product identified damage to the sterile packaging (blister).Sterility has not been compromised.Evaluation also confirmed there is white debris inside the sterile packaging which is consistent with the appearance of foam debris from the foam packaging inside the sterile barrier.The reported event is confirmed.Review of the device history records identified no deviations or anomalies during manufacturing related to the reported event.The likely condition of the device when it left zimmer biomet is conforming to specification.The root cause of the reported event for blister damage can be attributed to transit damage and a packaging design issue.Upon further investigation, it has been determined that the packaging meets the acceptable criteria specifications and the sterility has not been breached.This event is no longer considered reportable.Therefore, the initial report should be voided.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 information on the reported event.
 
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Brand Name
TPRLC 133 T1 PPS HO 12X144MM
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 Key14352283
Report Number0001825034-2022-01193
Device Sequence Number14666691
Product Code LZO
UDI-Device Identifier00880304489752
UDI-Public(01)00880304489752(17)300429(10)6778794
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K200196
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 06/23/2022
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 Number51-104120
Device Lot Number6778794
Was Device Available for Evaluation? Device Returned to Manufacturer
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 04/18/2022
Supplement Date Received by Manufacturer06/20/2022
Initial Report FDA Received Date05/11/2022
Supplement Report FDA Received Date06/24/2022
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/29/2020
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
NI
Patient Sequence Number1
Patient SexUnknown
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