MAUDE Adverse Event Report: ZIMMER BIOMET, INC. ALLEN PLUG; PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, CEMENTED

Catalog Number	00801102032
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code	Insufficient Information (4580)
Type of Reportable Event	Death
Additional Manufacturer Narrative
(b)(4).D10: cat#: 00585004603, lot#: 67753852, cat#: 00585003014, lot#: 66601091, cat#: 00585204030, lot#: 67348514, cat#: 00598801016, lot#: 67638151, cat#: 00585205014, lot#: 67740616, cat#: 00585004604, lot#: 66018620, cat#: 00585001396, lot#: 67536093, cat#: 00588000500, lot#: 67243960, cat#: 00585004301, lot#: 67524738, cat#: 00223200418, lot#: 67849377.G2: foreign - event occurred in australia.The device will not be returned for analysis; however, an investigation of the reported event is in progress.Once the investigation is completed, a supplemental medwatch 3500a will be submitted.
Event or Problem Description
It was reported that the patient underwent a knee surgery and subsequently passed away in the following days of the procedure, on an unknown date, due to unknown medical complications.Attempts have been made and no further information has been provided.

• Brand Name: ALLEN PLUG
• Common Device Name: PROSTHESIS, HIP, SEMI-CONSTRAINED, METAL/POLYMER, CEMENTED
• 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 Key: 25888960
• Report Number: 0001822565-2026-02643
• Device Sequence Number: 9790296
• Product Code: JDI
• UDI-Device Identifier: 00889024433021
• UDI-Public: (01)00889024433021(17)290507(10)66528224
• Combination Product (Y/N): N
• Initial Reporter Country: AS
• PMA/510(K) Number: K001733
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2026
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Foreign,Health Professional,Company Representative
• Initial Reporter Occupation: Physician
• Type of Report: Initial
• Report Date (Section B): 07/20/2026

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 Catalogue Number: 00801102032
• Device Lot Number: 66528224
• 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: 06/28/2026
• Initial Report FDA Received Date: 07/21/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 05/08/2024
• Is the Device Labeled for Single Use? (Y/N): Yes
• Usage of Device: Initial
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Death
• Patient Sex: Female