| Brand Name | TPRLC 133 T1 PPS HO 14X148MM |
| Common Device Name | PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/CERAMIC/POLYMER |
| Manufacturer (Section D) |
| ZIMMER BIOMET, INC. |
| 56 e. bell drive |
| p.o. box 587 |
| warsaw IN 46581 |
|
| Manufacturer (Section G) |
| ZIMMER BIOMET, INC. |
| 56 e. bell drive |
| p.o. box 587 |
| warsaw IN 46581 |
|
| Manufacturer Contact |
|
jennifer
rapsavage
|
| 56 e. bell dr. |
| warsaw, IN 46582
|
|
5745260384
|
|
| MDR Report Key | 24817374 |
| Report Number | 0001825034-2026-00874 |
| Device Sequence Number | 6145868 |
| Product Code |
LZO
|
| UDI-Device Identifier | 00880304491847 |
| UDI-Public | (01)00880304491847(17)260703(10)3821915 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| PMA/510(K) Number | K200196 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Company Representative |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
04/08/2026 |
| 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 Expiration Date | 07/03/2026 |
| Device Catalogue Number | 51-104140 |
| Device Lot Number | 3821915 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Date Returned to Manufacturer | 03/12/2026 |
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 04/02/2026 |
| Initial Report FDA Received Date | 04/08/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 07/03/2016 |
| 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 |
| Patient Sex | Unknown |