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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 18X156MM; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 18X156MM; PROSTHESIS, HIP Back to Search Results
Catalog Number 51-104180
Medical Device Problem Code Manufacturing, Packaging or Shipping Problem (2975)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/10/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that when opening the implant, it was found to have perforated through the plastic container.There was no patient involvement.Attempts have been made and no further information is available.
 
Additional Manufacturer Narrative
(b)(4).Visual examination of the returned product/provided photos identified damage to the sterile packaging (blister).Sterility has been compromised.The reported event has been confirmed by evaluation of the returned product/provided photos.Device history record (dhr) was reviewed and no discrepancies related to the reported event were found.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 will be filed accordingly.Zimmer biomet will continue to monitor for trends.
 
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Brand Name
TPRLC 133 T1 PPS HO 18X156MM
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 Key18607580
Report Number0001825034-2024-00167
Device Sequence Number14139849
Product Code LZO
UDI-Device Identifier00880304499263
UDI-Public(01)00880304499263(17)310819(10)7083678
Combination Product (Y/N)N
Initial Reporter StateWI
Initial Reporter CountryUS
PMA/510(K) Number
K200196
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Distributor
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 01/30/2024
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 Catalogue Number51-104180
Device Lot Number7083678
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/15/2024
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 01/10/2024
Initial Report FDA Received Date01/30/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/19/2021
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
Patient Sequence Number1
Patient SexUnknown
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