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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. COMPR 3-IN-1 IMPACTOR; Shoulder Prosthesis, Reverse Configuration

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ZIMMER BIOMET, INC. COMPR 3-IN-1 IMPACTOR; Shoulder Prosthesis, Reverse Configuration Back to Search Results
Catalog Number 110028055
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/17/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).The customer has indicated that the product is in process of being 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 a glenosphere impactor was found cracked during central sterile processing.There was no patient involvement.Attempts have been made and no further information has been provided.
 
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Brand Name
COMPR 3-IN-1 IMPACTOR
Common Device Name
Shoulder Prosthesis, Reverse Configuration
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 Key24857359
Report Number0001825034-2026-00925
Device Sequence Number18451292
Product Code PHX
UDI-Device Identifier00880304731301
UDI-Public(01)00880304731301(11)180131(10)827340
Combination Product (Y/N)N
Initial Reporter StateIA
Initial Reporter CountryUS
PMA/510(K) Number
K193373
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Distributor
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 09/29/2026
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 Number110028055
Device Lot Number827340
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer03/23/2026
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/17/2026
Supplement Date Received by Manufacturer09/11/2026
Initial Report FDA Received Date04/13/2026
Supplement Report FDA Received Date09/29/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/31/2018
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 Unknown
Patient Sequence Number1
Patient SexUnknown
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