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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TPRLC 133 FP TYPE1 PPS HO 7.0; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. TPRLC 133 FP TYPE1 PPS HO 7.0; 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 09/02/2022
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during inspection at the warehouse, the inner pouch was found to be torn.There was no patient involvement.Attempts have been made and additional information on the reported event is unavailable at this time.
 
Additional Manufacturer Narrative
(b)(4).Report source: japan.The product is in process of being returned to zimmer biomet for the 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 - 02212, 0001825034 - 2022 - 02214.
 
Event or Problem Description
No additional event information to report at this time.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Visual evaluation of the returned product/photographs provided found all three inner pouches were torn near the pre-tear location however none had torn into the sealed pouch.Review of the device history records identified no deviations or anomalies during manufacturing related to the reported event.The 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 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.
 
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Brand Name
TPRLC 133 FP TYPE1 PPS HO 7.0
Common Device Name
PROSTHESIS, HIP
Manufacturer (Section D)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer (Section G)
ZIMMER BIOMET, INC.
56 e. bell drive
p.o. box 587
warsaw IN 46581
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key15487018
Report Number0001825034-2022-02213
Device Sequence Number5212325
Product Code LZO
UDI-Device Identifier00880304489769
UDI-Public(01)00880304489769(17)290504(10)6543107
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
Report Source Foreign,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 11/15/2022
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 Number51-101070
Device Lot Number6543107
Was Device Available for Evaluation? Device Returned to Manufacturer
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/02/2022
Supplement Date Received by Manufacturer11/11/2022
Initial Report FDA Received Date09/26/2022
Supplement Report FDA Received Date11/15/2022
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/04/2019
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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