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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER SURGICAL, INC. FAN SPRAY KIT; LAVAGE, JET

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ZIMMER SURGICAL, INC. FAN SPRAY KIT; LAVAGE, JET Back to Search Results
Catalog Number 00515047501
Medical Device Problem Codes Inability to Irrigate (1337); Noise, Audible (3273)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/23/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This complaint is recorded by zimmer biomet under (b)(4).Functional testing of the returned product found the device would not power on with the original battery pack but did power on and function normally in both modes when connected to a lab battery pack.Visual inspection of the interior of the pack found the batteries had leaked electrolyte inside of the pack.There did not appear to be damage to the wiring of the pack.Review of the device history record identified no deviations or anomalies during manufacturing related to the reported event.The root cause of the reported issue is attributed to a manufacturing and/or design issue.The reported event was confirmed.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.E1 telephone number: (b)(6).G2 country: japan.
 
Event or Problem Description
It was reported that during surgery the device did not work at all as it did not spray saline water although the motor was working.There was also an abnormal sound.There was no patient impact but there was a 0-15 minute delay in the procedure while an alternate device was being prepared.During product evaluation it was found that the batteries leaked electrolyte.Due diligence is complete and there is no additional information available.
 
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Brand Name
FAN SPRAY KIT
Common Device Name
LAVAGE, JET
Manufacturer (Section D)
ZIMMER SURGICAL, INC.
200 west ohio avenue
dover OH 44622
Manufacturer (Section G)
ZIMMER SURGICAL, INC.
200 west ohio avenue
dover OH 44622
Manufacturer Contact
jennifer rapsavage
56 e. bell drive
warsaw, IN 46582
5745260384
MDR Report Key24179882
Report Number0001526350-2026-00078
Device Sequence Number13150880
Product Code FQH
UDI-Device Identifier00889024375161
UDI-Public(01)00889024375161(17)270809(10)78867107
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 01/26/2026
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 Number00515047501
Device Lot Number78867107
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/15/2025
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 01/20/2026
Initial Report FDA Received Date01/26/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/13/2024
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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