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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER SURGICAL, INC. SHOWER SPRAY KIT; LAVAGE, JET

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ZIMMER SURGICAL, INC. SHOWER SPRAY KIT; LAVAGE, JET Back to Search Results
Model Number N/A
Medical Device Problem Codes Explosion (4006); Powder Leak (4069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/21/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This complaint is recorded by zimmer biomet under (b)(4).A follow up/ final report will be submitted once investigation is complete.G2: foreign country - australia.
 
Event or Problem Description
It was reported during setup prior to surgery that the battery pack had exploded.One battery is visibly damaged with black particles and battery acid contained within the packaging.There is no harm or delay reported.Due diligence is complete and there is no additional information available.
 
Additional Manufacturer Narrative
No product was returned.Based on the images provided, there is evidence of battery expulsion.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
There is no additional event information available.
 
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Brand Name
SHOWER SPRAY KIT
Common Device Name
LAVAGE, JET
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 Key20575672
Report Number0001526350-2024-01330
Device Sequence Number8095228
Product Code FQH
UDI-Device Identifier00889024375215
UDI-Public(01)00889024375215(17)270123(10)74889456
Combination Product (Y/N)N
Initial Reporter CountryAS
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 Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 04/28/2025
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 Number00515049500
Device Lot Number74889456
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 10/22/2024
Supplement Date Received by Manufacturer04/25/2025
Initial Report FDA Received Date10/31/2024
Supplement Report FDA Received Date04/28/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/07/2024
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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