| Brand Name | PERSONA TIB STM 5 DEG SZ C R |
| Common Device Name | Prosthesis, Knee, Patello/Femorotibial, Semi-Constrained, Uncemented, Porous |
| Manufacturer (Section D) |
| Zimmer Orthopaedic Mfg. Ltd. |
| building no 2 east park |
| shannon industrial estate |
| shannon, county clare |
| EI |
|
| Manufacturer (Section G) |
| Zimmer Orthopaedic Mfg. Ltd. |
| building no 2 east park |
| shannon industrial estate |
| shannon, county clare |
|
EI
|
|
| Manufacturer Contact |
|
jennifer
rapsavage
|
| 56 e. bell dr. |
| warsaw, IN 46582
|
|
+1(574)526-0384
|
|
| MDR Report Key | 50859875 |
| Report Number | 3007963827-2026-00434 |
| Device Sequence Number | 21206881 |
| Product Code |
MBH
|
| UDI-Device Identifier | 00889024471023 |
| UDI-Public | (01)00889024471023(17)330917(10)66187911 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | AS |
| PMA/510(K) Number | K172524 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2025 |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional |
| Initial Reporter Occupation |
Physician
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/22/2026 |
| 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? |
Yes
|
| Device Catalogue Number | 42532006402 |
| Device Lot Number | 66187911 |
| 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 | 08/31/2026 |
| Initial Report FDA Received Date | 09/22/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 09/26/2023 |
| 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 |
| Outcome Attributed to Adverse Event |
Hospitalization;
Required Intervention;
|
| Patient Sex | Female |