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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER SURGICAL, INC. 30IN. (76CM) DISPOSABLE CUFF W/PLC - SP, SB; TOURNIQUET, PNEUMATIC

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ZIMMER SURGICAL, INC. 30IN. (76CM) DISPOSABLE CUFF W/PLC - SP, SB; TOURNIQUET, PNEUMATIC Back to Search Results
Catalog Number 60707510500
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 12/05/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This event has been recorded by zimmer biomet under (b)(4).E1 telephone number: (b)(6).G2 foreign: japan.Evaluation and investigation are in process.Once the investigation is complete, a supplemental report will be filed.
 
Event or Problem Description
It was reported that during incoming inspection, this product was found to be nonconforming, sterile seal was breached.There was no patient involvement, impact, or harm.Due diligence information complete.
 
Additional Manufacturer Narrative
This event has been recorded by zimmer biomet under (b)(4).This medwatch is being filed to relay additional information.The following sections were updated/corrected: visual examination of the returned product/provided pictures identified the pouch was not sealed for one of the cuff packages.Review of the device history record identified no deviations or anomalies during manufacturing related to the reported event.A definitive root cause cannot be determined.The event is confirmed.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 available.
 
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Brand Name
30IN. (76CM) DISPOSABLE CUFF W/PLC - SP, SB
Common Device Name
TOURNIQUET, PNEUMATIC
Manufacturer (Section D)
ZIMMER SURGICAL, INC.
200 west ohio avenue
dover OH 44622
Manufacturer (Section G)
ZIMMER SURGICAL, INC.
200 west ohio avenue
dover OH 44622
Manufacturer Contact
jennifer rapsavage
56 e. bell drive
warsaw, IN 46582
5745260384
MDR Report Key18376124
Report Number0001526350-2023-01677
Device Sequence Number7722731
Product Code KCY
UDI-Device Identifier00889024382749
UDI-Public(01)00889024382749(17)260905(10)72608051
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
EXEMPT
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) 03/20/2024
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 Health Professional
Device Expiration Date09/05/2026
Device Catalogue Number60707510500
Device Lot Number72608051
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 12/06/2023
Supplement Date Received by Manufacturer03/18/2024
Initial Report FDA Received Date12/21/2023
Supplement Report FDA Received Date03/20/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/06/2023
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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