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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 10MM 8-11/GH; PROSTHESIS, KNEE

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ZIMMER ORTHOPAEDIC MFG. LTD. PERSONA MC VE ASF R 10MM 8-11/GH; PROSTHESIS, KNEE Back to Search Results
Catalog Number 42522100910
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Loss of Range of Motion (2032)
Date of Event 02/19/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
(b)(4) d10: medical product: femur trabecular metal cruciate retaining (cr) standard porous: catalog#42502806602, lot#64947252; psn tib stm 5 deg sz g r: catalog#42532007902, lot#64821923 g2: foreign: australia.Customer has indicated that the product will not be returned to zimmer biomet for investigation per hospital policy.The investigation is in process.Upon completion of the investigation, a follow-up mdr will be submitted.
 
Event or Problem Description
It was reported that a patient underwent an initial total knee arthroplasty.Approximately four (4) years and four (4) months post-implantation, the patent underwent revision surgery due to stiffness.All components were replaced without reported complication.It was further reported that all available information has been provided.
 
Additional Manufacturer Narrative
This follow-up report is being submitted to relay additional information.The following sections have been updated: b4; b5; g3; h2; h3; h6; h10; h11.Visual examination of the provided picture identified an explanted articular surface, femoral component, and stemmed tibial tray.The femur and tibia show bony ingrowth attached.All devices have biological components, such as blood, attached.Medical records were not provided.The device history record was reviewed and no discrepancies relevant to the reported event were found.Root cause was unable to be determined.Reported event was unable to be 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.
 
Event or Problem Description
No further event information is available at the time of this report.
 
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Brand Name
PERSONA MC VE ASF R 10MM 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 Key24613411
Report Number3007963827-2026-00103
Device Sequence Number18687411
Product Code MBH
UDI-Device Identifier00889024468498
UDI-Public(01)00889024468498(17)260314(10)64973143
Combination Product (Y/N)N
Initial Reporter CountryAS
PMA/510(K) Number
K150090
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2021
Device Explanted Year2026
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 04/14/2026
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? No
Operator of Device Lay User/Patient
Device Expiration Date03/14/2026
Device Catalogue Number42522100910
Device Lot Number64973143
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 02/19/2026
Supplement Date Received by Manufacturer04/07/2026
Initial Report FDA Received Date03/16/2026
Supplement Report FDA Received Date04/14/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/08/2021
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.
Outcome Attributed to Adverse Event Hospitalization; Required Intervention;
Patient Age54 YR
Patient SexUnknown
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