FDA Adverse Event Malfunction Summary report: N

TPRLC 133 MP TYPE1 PPS HO 12.0

MDR report key: 20128852 · Received September 3, 2024

Report

Report Number
0001825034-2024-02140
Event Type
Malfunction
Date Received
September 3, 2024
Date of Event
August 15, 2024
Report Date
January 7, 2025
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWA
UDI-DI
00880304513471
PMA / PMN Number
K110400
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10: 51-104160 TPRLC 133 T1 PPS HO 16X152MM 7130643, 51-104160 TPRLC 133 T1 PPS HO 16X152MM 7130685, 51-105160 TPRLC XR T1 PPS 16X152MM 7136707. G2: FOREIGN: JAPAN. 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.

Additional Manufacturer Narrative · 0

(B)(4). THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2024-02139, 0001825034-2024-02141, 0001825034-2024-02142. VISUAL EVALUATION OF THE RETURNED PRODUCT/PROVIDED PHOTOS IDENTIFIED DAMAGE TO THE STERILE PACKAGING (BLISTER). STERILITY HAS BEEN COMPROMISED. THE EVENT IS CONFIRMED BASED ON THE EVALUATION OF THE RETURNED PRODUCT AND PROVIDED PHOTOS. DHR WAS REVIEWED AND NO DISCREPANCIES RELATED TO THE REPORTED EVENT WERE FOUND. THE CONDITION OF THE DEVICE WHEN IT LEFT ZIMMER BIOMET IS CONSIDERED CONFORMING TO SPECIFICATION. THE ROOT CAUSE OF THE REPORTED EVENT CAN BE ATTRIBUTED TO TRANSIT DAMAGE AND A PACKAGING DESIGN ISSUE. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE INSPECTED STOCK ITEMS HAD DAMAGE TO THE STERILE PACKAGING. THERE WAS NO PATIENT INVOLVEMENT. IT WAS REPORTED THAT NO FURTHER INFORMATION IS PROVIDED.

Description of Event or Problem · 0

NO ADDITIONAL EVENT INFORMATION TO REPORT AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1834336 TPRLC 133 MP TYPE1 PPS HO 12.0 PROSTHESIS, HIPS KWA ZIMMER BIOMET, INC. N/A 6232309 00880304513471

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown