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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 11X142MM; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 11X142MM; PROSTHESIS, HIP Back to Search Results
Catalog Number 51-104110
Medical Device Problem Code Manufacturing, Packaging or Shipping Problem (2975)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/07/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).D10: 51-145150 item name tprlc xr mp t1 pps 15x115mm lot # 6041831 51-109060 item name tloc 133 mp sp t1ppsho 6x97.5 lot # 7183064 51-107170 item name tprlc 133 mp type1 pps ho 17.0 lot # 7269926.51-100040 item name tprlc 133 fp type1 pps so 4.0 lot # 7247907.G2: foreign: japan customer has indicated that the product is in process of being returned to zimmer biomet for investigation.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event or Problem Description
It was reported that while inspecting the packaging, it was found with inner package was damage.There was no patient involvement.There is no further 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;d9;g3;h2;h3;h6;h10.Product returned and evaluated.Visual evaluation of the returned product/provided photos identified damage to the sterile packaging (pouch).Sterility had been compromised.Review of the device history records identified no deviations or anomalies during manufacturing related to the reported event.Reported event is not related to a combination of products; therefore, a compatibility review is not applicable.The reported event did not occur in an operating room or as part of a medical procedure; medical records are not available for review.The condition of the device when it left zimmer biomet is considered conforming to specification.The root cause of the reported event can be attributed to transit damage and a packaging design issue.The reported event has been confirmed by evaluation of the returned product and provided photos.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.
 
Event or Problem Description
No further event information is available at the time of this report.
 
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Brand Name
TPRLC 133 T1 PPS HO 11X142MM
Common Device Name
PROSTHESIS, 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 Key21739543
Report Number0001825034-2025-00931
Device Sequence Number14458542
Product Code LZO
UDI-Device Identifier00880304489714
UDI-Public(01)00880304489714(17)290922(10)6636408
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K200196
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Company Representative,Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 06/26/2025
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 Catalogue Number51-104110
Device Lot Number6636408
Was Device Available for Evaluation? Device Returned to Manufacturer
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/07/2025
Supplement Date Received by Manufacturer06/13/2025
Initial Report FDA Received Date04/01/2025
Supplement Report FDA Received Date06/26/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/22/2019
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
Concomitant Medical Products
and Therapy/Usage Dates
PLEASE SEE H11
Patient SexUnknown
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