| Brand Name | Z.S.G.M. CUTTER 1.5:1 RATIO ( CAUTION: SHARP ) |
| Common Device Name | EXPANDER, SURGICAL, SKIN GRAFT |
| 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 Key | 21891792 |
| Report Number | 0001526350-2025-00532 |
| Device Sequence Number | 8053197 |
| Product Code |
FZW
|
| UDI-Device Identifier | 00889024375444 |
| UDI-Public | (01)00889024375444(11)210930(10)65239073 |
| Combination Product (Y/N) | N |
| Initial Reporter State | MO |
| Initial Reporter Country | US |
| PMA/510(K) Number | PREAMENDMENT |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
04/23/2025 |
| 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 Number | 00770301500 |
| Device Lot Number | 65239073 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Date Returned to Manufacturer | 10/01/2024 |
| 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 | 04/17/2025 |
| Initial Report FDA Received Date | 04/23/2025 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 10/15/2021 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Reuse
|
| Patient Sequence Number | 1 |
Concomitant Medical Products and Therapy/Usage Dates | CUTTER 2:1.PN 00770302000.LN 65133588.SN 1516972; CUTTER 3:1.PN 00770303000.LN 65104974.SN 1516880; CUTTER 4:1.PN 00770304000.LN 65104975.SN 1516900; MESHER.PN 00770100000.LN 64803554.SN 8021; RATCHET HANDLE.PN: 00770102200.LN: 65013530. |
| Patient Sex | Unknown |