FDA Adverse Event Malfunction Summary report: N

TPRLC 133 T1 PPS SO 14X148MM

MDR report key: 20639771 · Received November 8, 2024

Report

Report Number
0001825034-2024-02630
Event Type
Malfunction
Date Received
November 8, 2024
Date of Event
October 15, 2024
Report Date
March 4, 2025
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LZO
UDI-DI
00880304491816
PMA / PMN Number
K101086
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED/CORRECTED UPDATED: B4, G3, G6, H2, H6, H11. VISUAL EVALUATION OF THE RETURNED PRODUCT/PROVIDED PHOTOS IDENTIFIED DAMAGE TO THE STERILE PACKAGING (BLISTER). STERILITY HAS NOT BEEN COMPROMISED. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. THE REPORTED EVENT DID NOT OCCUR IN AN OPERATING ROOM OR AS PART OF A MEDICAL PROCEDURE; MEDICAL RECORDS ARE NOT AVAILABLE FOR REVIEW. 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. THE REPORTED EVENT HAS BEEN CONFIRMED BY EVALUATION OF THE RETURNED PRODUCT AND PROVIDED PHOTOS. THE DEVICE EVALUATION FOUND THE PRODUCT TO BE CONFORMING AND STERILITY NOT COMPROMISED. FURTHER, THE EVENT DID NOT CONTRIBUTE TO A SERIOUS INJURY; THEREFORE, THIS WOULD NOT BE CONSIDERED A REPORTABLE EVENT. 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.

Additional Manufacturer Narrative · 0

(B)(4). D10: 51-106140 ITEM NAME TPRLC 133 MP TYPE1 PPS SO 14.0 LOT # 6994250 51-103150 ITEM NAME TPRLC 133 T1 PPS SO 15X150MM LOT # 7005059 51-145120 ITEM NAME TPRLC XR MP T1 PPS 12X109MM LOT# 7320778 51-107120 ITEM NAME TPRLC 133 MP TYPE1 PPS HO 12.0 LOT# 7096392 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.

Description of Event or Problem · 0

THERE IS NO UPDATE TO THE PRIOR EVENT DESCRIPTION PROVIDED.

Description of Event or Problem · 0

IT WAS REPORTED WHEN INSPECTING CIRCULATED PRODUCT THAT THE STERILE PACKAGING WAS FOUND DAMAGED. THERE WAS NO PATIENT INVOLVEMENT. THERE IS NO ADDITIONAL INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1951830 TPRLC 133 T1 PPS SO 14X148MM PROSTHETIC, HIP LZO ZIMMER BIOMET, INC. N/A 6423079 00880304491816

Patients

Seq Age Sex Outcome Treatment
1 NA Prefer Not To Disclose