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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER ORTHOPAEDIC MFG. LTD. PERSONA MC VE ASF R 11MM 8-11/GH; PROSTHESIS, KNEE

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ZIMMER ORTHOPAEDIC MFG. LTD. PERSONA MC VE ASF R 11MM 8-11/GH; PROSTHESIS, KNEE Back to Search Results
Catalog Number 42522100911
Medical Device Problem Code Positioning Failure (1158)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/03/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).D10: medical product: spiked keel right size g osseoti tibia: catalog#42535007902, lot#67458887.The device will not be returned for analysis per hospital policy; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental medwatch 3500a will be submitted.
 
Event or Problem Description
It was reported that during an initial total knee arthroplasty, the articular surface would not seat on the tibial tray.A backup device was used to complete the procedure without additional complication.There was no patient impact and no adverse events have been reported as a result of the malfunction.All available information has been provided.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections were updated: b4; b5; d2; g1; g3; g6; h1; h2; h3; h6.The event cannot be confirmed.No product was returned, or pictures provided; visual and dimensional evaluations could not be performed.The device history record was reviewed and no discrepancies relevant to the reported event were found.Medical records were not provided.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
PERSONA MC VE ASF R 11MM 8-11/GH
Common Device Name
PROSTHESIS, KNEE
Manufacturer (Section D)
ZIMMER ORTHOPAEDIC MFG. LTD.
building no 2 east park
shannon industrial estate
shannon, county clare
Manufacturer (Section G)
ZIMMER ORTHOPAEDIC MFG. LTD.
building no 2 east park
shannon industrial estate
shannon, county clare
Manufacturer Contact
jennifer rapsavage
56 e. bell dr.
warsaw, IN 46582
5745260384
MDR Report Key23696751
Report Number3007963827-2025-00482
Device Sequence Number10231756
Product Code MBH
UDI-Device Identifier00889024468504
UDI-Public(01)00889024468504(17)300616(10)67366472
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
K150090
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Company Representative,Distributor
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 02/24/2026
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 Number42522100911
Device Lot Number67366472
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 11/03/2025
Supplement Date Received by Manufacturer02/24/2026
Initial Report FDA Received Date12/02/2025
Supplement Report FDA Received Date02/26/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/16/2025
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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