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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER BIOMET, INC. PERSONA 0° KEEL TIBIAL PEG DRILL; INSTRUMENT, KNEE

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ZIMMER BIOMET, INC. PERSONA 0° KEEL TIBIAL PEG DRILL; INSTRUMENT, KNEE Back to Search Results
Model Number N/A
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the tip of a drill broke off.The surgical technique was utilized, there was no surgical delay, there were no foreign bodies retained.Attempts have been made and no further information has been provided.
 
Additional Manufacturer Narrative
(b)(4).H6: proposed component code: mechanical (g04) - drill product has been received by zimmer biomet and the investigation is in process.Once the investigation has been completed, a follow-up mdr will be submitted.
 
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Brand Name
PERSONA 0° KEEL TIBIAL PEG DRILL
Common Device Name
INSTRUMENT, 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 Key25535817
Report Number0001822565-2026-01946
Device Sequence Number18469616
Product Code JWH
UDI-Device Identifier00889024632455
UDI-Public(01)00889024632455(10)66435010
Combination Product (Y/N)N
Initial Reporter StateOR
Initial Reporter CountryUS
PMA/510(K) Number
K221479
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 Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 06/16/2026
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 Model NumberN/A
Device Catalogue Number42539901831
Device Lot Number66435010
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/02/2026
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/22/2026
Initial Report FDA Received Date06/17/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/22/2024
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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