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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER SURGICAL, INC. ZIMMER® S.G. CARRIER; EXPANDER, SURGICAL, SKIN GRAFT

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ZIMMER SURGICAL, INC. ZIMMER® S.G. CARRIER; EXPANDER, SURGICAL, SKIN GRAFT Back to Search Results
Model Number N/A
Medical Device Problem Code Delivered as Unsterile Product (1421)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/08/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This complaint is recorded by zimmer biomet under cmp (b)(4) a follow up/ final report will be submitted once investigation is complete.G2 - foreign country - japan 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
It was reported that there was a hair like substance during incoming inspection.There is no harm or delay reported.Due diligence is complete.
 
Additional Manufacturer Narrative
Visual inspection confirmed there was a hair sealed inside the package of 1 of the carriers.Per packaging material inspection guidelines zpc 8.400, the size of the debris is over specification and therefore the packaging is non-conforming.Review of the device history record identified no deviations or anomalies during manufacturing related to the reported event.The root cause of the reported issue is attributed to manufacturing process.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
There is no additional event information available.
 
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Brand Name
ZIMMER® S.G. CARRIER
Common Device Name
EXPANDER, SURGICAL, SKIN GRAFT
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 Key19249044
Report Number0001526350-2024-00535
Device Sequence Number7332665
Product Code FZW
UDI-Device Identifier00889024380165
UDI-Public(01)00889024380165(17)280515(10)66038884
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
PREAMENDMENT
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) 09/20/2024
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 Model NumberN/A
Device Catalogue Number00770800010
Device Lot Number66038884
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/01/2024
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/08/2024
Supplement Date Received by Manufacturer09/19/2024
Initial Report FDA Received Date05/06/2024
Supplement Report FDA Received Date09/20/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/07/2023
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
Patient Sequence Number1
Patient SexPrefer Not To Disclose
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