MAUDE Adverse Event Report: ZIMMER BIOMET, INC. CRUCIATE RETAINING LEFT SIZE 12 PPS STANDARD FEMUR; PROSTHESIS, KNEE

Model Number	N/A
Medical Device Problem Codes	Peeled/Delaminated (1454); Osseointegration Problem (3003)
Health Effect - Clinical Codes	Inadequate Osseointegration (2646); Insufficient Information (4580)
Date of Event	11/19/2024
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
(b)(4).Unknown, tibial component, unknown lot.Unknown, articular surface, unknown lot.Customer has indicated that the product will not be 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 the patient underwent an initial knee surgery.A femoral component revision due to pps coating delamination from the metal.Attempts have been made and no further information has been provided.
Event or Problem Description
It was reported that the patient underwent a left knee arthroplasty revision to address inadequate osseointegration.During the procedure, the tibial and femoral components were noted to not have any bony ingrowth.The femoral component was also noted to be delaminated.
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.After further communication from rep the submitted report 0001822565-2025-04405 is a duplicate of this report so all the information is being updated in this follow-up report 0001822565-2025-04558-1.The following sections were updated: updated: a1; a2; a3; b1; b4; b5; d2; d6; d9; d10; e1; e3; g1; g3; g6; h1; h2; h6; h10.D10: persona porous 0 degree tibial component size g left catalog #: 42535007901 lot #: 66671804.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
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 complaint could not be confirmed.Visual examination of the returned product identified signs of implant & use (gouges) and bone cement remains.A further review of the femur identified scarring, smearing and knicks that appear to be consistent with the removal of the implant as part of the revision surgery.The device history record was reviewed and no discrepancies relevant to the reported event were found.Review of complaint history found no additional related issues for this item and the reported part and lot combination.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.

• Brand Name: CRUCIATE RETAINING LEFT SIZE 12 PPS STANDARD FEMUR
• 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 Key: 23827066
• Report Number: 0001822565-2025-04558
• Device Sequence Number: 8954726
• Product Code: JWH
• UDI-Device Identifier: 00889024631397
• UDI-Public: (01)00889024631397(17)340926(10)66807955
• Combination Product (Y/N): N
• Initial Reporter State: KS
• Initial Reporter Country: US
• PMA/510(K) Number: K221479
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2025
• Device Explanted Year: 2025
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional,Distributor
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 05/21/2026

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 Model Number: N/A
• Device Catalogue Number: 42508607401
• Device Lot Number: 66807955
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• 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: 11/20/2025
• Supplement Date Received by Manufacturer: 01/22/2025; 05/21/2026
• Initial Report FDA Received Date: 12/17/2025
• Supplement Report FDA Received Date: 02/19/2026; 05/28/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 09/28/2024
• 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 Number: 1
• Concomitant Medical Products and Therapy/Usage Dates: SEE H11; SEE H11
• Outcome Attributed to Adverse Event: Required Intervention; Hospitalization
• Patient Age: 54 YR
• Patient Sex: Male