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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. BIOMET PRIMARY MODULAR CEMENTED TIBIAL TRAY 71MM; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. BIOMET PRIMARY MODULAR CEMENTED TIBIAL TRAY 71MM; 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 03/23/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).The 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 the tibial tray outer packaging was received damaged, but there did not appear to be any visible damage to the exterior sterile packaging.However, upon opening the package in the sterile field, a hole was identified on the interior sterile packaging of the implant.Another device was used to complete the procedure.No adverse events were reported as a result of this malfunction.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Visual evaluation of the returned product found crush damage on the outer carton that corresponds with the crush damage on the inner sterile blisters.There is a puncture that penetrates both layers of tyvek.Sterility has been compromised.This complaint has been confirmed by evaluation of the returned product.The device history record was reviewed and no discrepancies relevant to the reported event were found.Medical records were not provided.The condition of the device when it left zimmer biomet is considered 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 report 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
BIOMET PRIMARY MODULAR CEMENTED TIBIAL TRAY 71MM
Common Device Name
PROSTHESIS, KNEE
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 Key16726343
Report Number0001825034-2023-00808
Device Sequence Number7209574
Product Code JWH
UDI-Device Identifier00887868558511
UDI-Public(01)00887868558511(17)330214(10)65897186
Combination Product (Y/N)N
Initial Reporter StateUT
Initial Reporter CountryUS
PMA/510(K) Number
K915132
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) 07/19/2023
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 Number141213
Device Lot Number65897186
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/04/2023
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 03/23/2023
Supplement Date Received by Manufacturer07/18/2023
Initial Report FDA Received Date04/12/2023
Supplement Report FDA Received Date07/20/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/14/2023
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 SexPrefer Not To Disclose
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