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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER MANUFACTURING B.V. PERSONA CEMENTED ALL POLY PATELLA 29MM; PROSTHESIS, KNEE

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ZIMMER MANUFACTURING B.V. PERSONA CEMENTED ALL POLY PATELLA 29MM; PROSTHESIS, KNEE Back to Search Results
Model Number N/A
Medical Device Problem Codes Insufficient Device Problem Information (3190); Loosening of Implant Not Related to Bone-Ingrowth (4002)
Health Effect - Clinical Codes Failure of Implant (1924); Pain (1994); Insufficient Information (4580)
Date of Event 01/23/2023
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient underwent a right knee arthroplasty revision of the articular surface and patellar components approximately two (2) years post-operatively due to unknown reasons.Attempts have been made; however, no additional information is available.
 
Additional Manufacturer Narrative
(b)(4).D10 - concomitant devices - persona medial congruent articular surface right 10mm catalog #: 42522100810, lot #: 65560779, persona cruciate retaining standard porous femoral component catalog #: 42502806802, lot #: 65098217, persona two-peg porous trabecular metal tibial tray right size f catalog #: 42530007502, lot #: 65569857.G2 - report source - foreign: event occurred in australia.The complainant has not yet indicated whether the product will 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
It was reported that the patient underwent a right knee arthroplasty revision of the articular surface and patellar components approximately two (2) years post-operatively due to loosening.Attempts have been made; however, no additional information is available.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections were updated: b1, b4, b5, g3, g6, h2, h6, h11.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.
 
Event or Problem Description
It was reported that the patient underwent a right knee arthroplasty revision approximately two (2) years post-operatively due to patellar loosening and pain.Attempts have been made, however, no additional information is available.
 
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 and corrected information.The following sections were updated: b4, g3, g6, h2, h3, h6, h11.The following sections were corrected: h4.The product was evaluated through manufacturing review, however, the reported event could not be confirmed.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 CEMENTED ALL POLY PATELLA 29MM
Common Device Name
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER MANUFACTURING B.V.
turpeaux industrial park
route #1 km 123.4 bldg #1
mercedita PR 00715
Manufacturer (Section G)
ZIMMER ORTHOPAEDIC MFG. LTD.
building no 2 east park
shannon industrial estate
shannon, county clare
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key21706689
Report Number0002648920-2025-00080
Device Sequence Number10010607
Product Code MBH
UDI-Device Identifier00889024247680
UDI-Public(01)00889024247680(17)270812(10)65550973
Combination Product (Y/N)N
Initial Reporter CountryAS
PMA/510(K) Number
K121771
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2023
Device Explanted Year2025
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,Followup,Followup
Report Date (Section B) 06/06/2025
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? Yes
Operator of Device Health Professional
Device Model NumberN/A
Device Catalogue Number42540200029
Device Lot Number65550973
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 03/04/2025
Supplement Date Received by Manufacturer03/26/2025
04/30/2025
06/03/2025
Initial Report FDA Received Date03/27/2025
Supplement Report FDA Received Date04/21/2025
05/23/2025
06/06/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/13/2022
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
Concomitant Medical Products
and Therapy/Usage Dates
SEE H11 NARRATIVE
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient SexMale
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