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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 15X150MM; PROSTHESIS, HIP

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ZIMMER BIOMET, INC. TPRLC 133 T1 PPS HO 15X150MM; PROSTHESIS, HIP Back to Search Results
Catalog Number 51-104150
Medical Device Problem Code Manufacturing, Packaging or Shipping Problem (2975)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/09/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that while inspecting the packaging, the sterile packaging was found damaged.There was no patient involvement.There is no further information available at the time of this report.
 
Additional Manufacturer Narrative
(b)(4).D10: 51-104120 item name tprlc 133 t1 pps ho 12x144mm lot# 7004917; d10: 51-109050 item name tloc 133 mp sp t1 pps ho 5x95 lot # 7224177; d10: 51-145170 item name tprlc xr mp t1 pps 17x119mm lot # 7338366; d10: 51-104140 item name tprlc 133 t1 pps ho 14x148mm lot # 6289615; d10: 51-107160 item name tprlc 133 mp type1 pps ho 16.0 lot # 7124269.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
No further information is available at the time of this report.
 
Additional Manufacturer Narrative
(b)(4).This follow-up report is being submitted to relay additional information.The following sections were updated: d9; g3; h2; h6; h10.Visual evaluation of the returned product/provided photos identified damage to the sterile packaging (blister).Sterility has not been compromised.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 product.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
TPRLC 133 T1 PPS HO 15X150MM
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 Key22140081
Report Number0001825034-2025-01576
Device Sequence Number12527805
Product Code KWA
UDI-Device Identifier00880304489776
UDI-Public(01)00880304489776(17)270420(10)6032531
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K101086
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) 09/16/2025
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 Number51-104150
Device Lot Number6032531
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 05/09/2025
Supplement Date Received by Manufacturer09/09/2025
Initial Report FDA Received Date06/04/2025
Supplement Report FDA Received Date09/16/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured04/20/2017
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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