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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. PSN FEM PS IMPACTOR PAD; PROSTHESIS, KNEE

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ZIMMER BIOMET, INC. PSN FEM PS IMPACTOR PAD; PROSTHESIS, KNEE Back to Search Results
Catalog Number 42509909300
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/24/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).G2- canada.H3- customer has indicated that the product will be returned to zimmer biomet for investigation.The investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event or Problem Description
It was reported that during cleaning of instruments, a femoral impactor pad was found fractured.The condition was identified during cleaning.There were no missing pieces, and there was no patient involvement.There is no additional information available.
 
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Brand Name
PSN FEM PS IMPACTOR PAD
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 Key24627298
Report Number0001822565-2026-00833
Device Sequence Number21045864
Product Code JWH
UDI-Device Identifier00889024232884
UDI-Public(01)00889024232884(10)64521523
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K113369
Number of Events Summarized1
Summary Report (Y/N)N
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) 07/09/2026
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 Other
Device Catalogue Number42509909300
Device Lot Number64521523
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 02/24/2026
Supplement Date Received by Manufacturer06/18/2026
Initial Report FDA Received Date03/18/2026
Supplement Report FDA Received Date07/09/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/10/2020
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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