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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 16X152MM; PROSTHESIS, HIPS

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ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 16X152MM; PROSTHESIS, HIPS Back to Search Results
Model Number N/A
Medical Device Problem Code Packaging Problem (3007)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/07/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).D10: 51-104140 tprlc 133 t1 pps ho 14x148mm 3570162, 51-109060 tloc 133 mp sp t1 ppsho 6x97.5 3894547, 51-100040 tprlc 133 fp type1 pps so 4.0 7292464.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 during inspection of the circulated items that the inner pouch was considered damaged.There was no patient involvement.It was reported that no further information is available.
 
Event or Problem Description
No additional event information to report at this time.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional and/or corrected information.Updated: d9, g3, g6, h2, h3, h6, h10.Visual evaluation of the returned product/provided photos identified damage to the sterile packaging (pouch).Sterility has been compromised.Review of the device history records identified no deviations or anomalies during manufacturing related to the reported event.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 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 provided photos/returned products.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.
 
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Brand Name
TPRLC 133 T1 PPS HO 16X152MM
Common Device Name
PROSTHESIS, HIPS
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 Key22122958
Report Number0001825034-2025-01550
Device Sequence Number6950337
Product Code LZO
UDI-Device Identifier00880304491854
UDI-Public(01)00880304491854(17)280320(10)6246573
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
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 09/17/2025
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 Lay User/Patient
Device Model NumberN/A
Device Catalogue Number51-104160
Device Lot Number6246573
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 05/07/2025
Supplement Date Received by Manufacturer09/09/2025
Initial Report FDA Received Date06/02/2025
Supplement Report FDA Received Date09/19/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/20/2018
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
Patient SexUnknown
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