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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. PERSONA CRUCIATE RETAINING TRABECULAR METAL NARROW POROUS FEMORAL COMPONENT; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. PERSONA CRUCIATE RETAINING TRABECULAR METAL NARROW POROUS FEMORAL COMPONENT; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes Erosion (1750); Pain (1994)
Date of Event 09/17/2024
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient underwent a left knee arthroplasty revision to address pain approximately two (2) years post-operatively.All components were revised except the tibial component without complication.Revision operative notes noted that the femur was soft from stress shielding.The tibial tray was well-fixed and all other components were replaced without complication.Attempts have been made, however, no additional information is available.
 
Additional Manufacturer Narrative
(b)(6) d10 - concomitant devices - persona cruciate retaining articular surface left 10mm catalog #: 42512000510 lot #: 65196837.Persona all-poly cemented patella 29mm catalog #: 42540200029 lot #: 65140171.Persona trabecular metal two-peg porous tibial component left size f catalog #: 42530007501 lot #: 65262147.G2 - report source - foreign: event occurred in australia.The complainant has indicated that the product will not be returned to zimmer biomet for investigation.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event or Problem Description
No further event information available at the time of this report.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections were updated: b4, g3, g6, h2, h3, h6, h11.H6 - component code - proposed code is mechanical (g04) - femur.Visual evaluation of pictures provided identified some damage to the patellar implant possibly from removal and medical records confirmed the reported event.The device history records were reviewed and no discrepancies were identified.A definitive root cause could not be determined with the information provided.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
PERSONA CRUCIATE RETAINING TRABECULAR METAL NARROW POROUS FEMORAL COMPONENT
Common Device Name
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer (Section G)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key20407684
Report Number0001822565-2024-03211
Device Sequence Number3579882
Product Code MBH
UDI-Device Identifier00889024470132
UDI-Public(01)00889024470132(17)291130(10)64592188
Combination Product (Y/N)N
Initial Reporter CountryAS
PMA/510(K) Number
K172524
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2022
Device Explanted 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) 02/07/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Operator of Device Health Professional
Device Model NumberN/A
Device Catalogue Number42502206801
Device Lot Number64592188
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 09/17/2024
Supplement Date Received by Manufacturer02/04/2025
Initial Report FDA Received Date10/09/2024
Supplement Report FDA Received Date02/07/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/03/2019
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 Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention; Hospitalization;
Patient Age67 YR
Patient SexUnknown
Patient Weight97 KG
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