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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. E1 VANGUARD PS TIB BRG 79/83X14; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. E1 VANGUARD PS TIB BRG 79/83X14; PROSTHESIS, KNEE Back to Search Results
Catalog Number EP-183664
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code Failure of Implant (1924)
Date of Event 07/03/2025
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient underwent an initial knee arthroplasty on an unknown date.Subsequently, the patient was revised due to ps vanguard insert post breakage.It was reported that no further information is available.
 
Additional Manufacturer Narrative
(b)(4).The device will not be returned for analysis; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental report will be submitted.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections were updated: b4; b5; g3; g6; h1; h2; h3; h6; h11.The reported event was confirmed by review of pictures.Visual examination of the provided pictures identified a post feature of the implant has fractured off from the body.The device history record was reviewed and no discrepancies relevant to the reported event were found.A definitive root cause cannot be determined.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.
 
Event or Problem Description
No further event information available at the time of this report.
 
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Brand Name
E1 VANGUARD PS TIB BRG 79/83X14
Common Device Name
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer (Section G)
ZIMMER BIOMET, INC.
1800 w. center st.
warsaw IN 46580
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key22578028
Report Number0001822565-2025-02625
Device Sequence Number4021635
Product Code JWH
UDI-Device Identifier00880304465657
UDI-Public(01)00880304465657(17)220307(10)132430
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
K171054
Number of Events Summarized1
Summary Report (Y/N)N
Device Explanted Year2025
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Distributor
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 11/12/2025
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 Lay User/Patient
Device Expiration Date03/07/2022
Device Catalogue NumberEP-183664
Device Lot Number132430
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 07/03/2025
Supplement Date Received by Manufacturer11/12/2025
Initial Report FDA Received Date07/23/2025
Supplement Report FDA Received Date11/12/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/07/2017
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
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient SexMale
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