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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TPRLC XR T1 PPS 13X146MM; PROTHESIS, HIPS

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ZIMMER BIOMET, INC. TPRLC XR T1 PPS 13X146MM; PROTHESIS, HIPS Back to Search Results
Model Number N/A
Medical Device Problem Code Packaging Problem (3007)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/05/2023
Type of Reportable Event Malfunction
Event or Problem Description
It was reported during circulation that the sterile package of the products was damaged.It was reported that no additional information is available.
 
Additional Manufacturer Narrative
(b)(4).D10: 51-100040 tprlc 133 fp type1 pps so 4.0 6644495, 51-145160 tprlc xr mp t1 pps 16x117mm 6541707.G2: foreign: japan multiple mdr reports were filed for this event, please see associated reports: 0001825034 - 2023 - 02476, 0001825034 - 2023 - 02477.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.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional and/or corrected information.Updated: d9, g3, g6, h2, h3, h6.Visual evaluation of the returned product/provided photos identified damage to the sterile packaging (blister).Sterility has not been compromised.The reported event has been confirmed by evaluation of the returned product and provided photos.Review of the device history records identified no deviations or anomalies during manufacturing related to the reported event.The reported event did not occur in an operating room or as part of a medical procedure; medical records are not available for review.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 and a packaging design issue.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 additional event information to report at this time.
 
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Brand Name
TPRLC XR T1 PPS 13X146MM
Common Device Name
PROTHESIS, HIPS
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 Key17995823
Report Number0001825034-2023-02478
Device Sequence Number6669584
Product Code LPH
UDI-Device Identifier00880304517141
UDI-Public(01)00880304517141(17)301028(10)6883665
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K120030
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) 01/29/2024
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 Lay User/Patient
Device Model NumberN/A
Device Catalogue Number51-105130
Device Lot Number6883665
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 10/05/2023
Supplement Date Received by Manufacturer01/29/2024
Initial Report FDA Received Date10/24/2023
Supplement Report FDA Received Date01/30/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/28/2020
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
N/A
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
SEE H10 NARRATIVE
Patient SexUnknown
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