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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. G7 HI-WALL E1 LINER 32MM D; PROSTHETIC, HIP

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ZIMMER BIOMET, INC. G7 HI-WALL E1 LINER 32MM D; PROSTHETIC, HIP 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 06/19/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that there was a hair found on the foam rubber cover inside the sterile packaging.The device was implanted since its primary packaging was not compromised.There is no additional information available at the time of this report.
 
Additional Manufacturer Narrative
(b)(4).G2: foreign: mexico.The device will not be returned for analysis as it remains implanted; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental medwatch will be submitted.
 
Event or Problem Description
There is no update to the prior event description provided.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.Visual evaluation of the returned product and provided photos found the packaging was previously opened.A hair-like fiber was found in the sterile packaging.As the product was returned opened, the source of the debris cannot be confirmed.Review of the device history records identified no deviations or anomalies during manufacturing.Medical records were not provided.A definitive root cause cannot be determined.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
G7 HI-WALL E1 LINER 32MM D
Common Device Name
PROSTHETIC, 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 Key19701218
Report Number0001825034-2024-01805
Device Sequence Number3653805
Product Code PBI
UDI-Device Identifier00880304527027
UDI-Public(01)00880304527027(17)240704(10)6584516
Combination Product (Y/N)N
Initial Reporter CountryMX
PMA/510(K) Number
K121874
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 08/09/2024
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 Date07/04/2024
Device Model NumberN/A
Device Catalogue Number010000926
Device Lot Number6584516
Was Device Available for Evaluation? No
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 06/19/2024
Supplement Date Received by Manufacturer08/08/2024
Initial Report FDA Received Date07/09/2024
Supplement Report FDA Received Date08/09/2024
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/04/2019
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 Unknown
Patient Sequence Number1
Patient Age36 YR
Patient SexFemale
Patient Weight58 KG
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