FDA Adverse Event Malfunction Summary report: N

TPRLC 133 MP TYPE1 PPS SO 15.0

MDR report key: 21460294 · Received February 25, 2025

Report

Report Number
0001825034-2025-00479
Event Type
Malfunction
Date Received
February 25, 2025
Date of Event
February 4, 2025
Report Date
June 24, 2025
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWA
UDI-DI
00880304514379
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: 51-104170 TPRLC 133 T1 PPS HO 17X154MM 6886909. 51-104120 TPRLC 133 T1 PPS HO 12X144MM 6992454. 51-145170 TPRLC XR MP T1 PPS 17X119MM 7224577. 51-106160 TPRLC 133 MP TYPE1 PPS SO 16.0 6700378 . 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

PRODUCT WAS RETURNED AND EVALUATED. VISUAL EVALUATION OF THE RETURNED PRODUCT/PROVIDED PHOTOS IDENTIFIED DAMAGE TO THE STERILE PACKAGING (BLISTER). STERILITY HAD NOT BEEN COMPROMISED. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. REPORTED EVENT IS NOT RELATED TO A COMBINATION OF PRODUCTS; THEREFORE, A COMPATIBILITY REVIEW IS NOT APPLICABLE. 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. 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 CIRCULATING ITEMS WERE INSPECTED, AND THE STERILE PACKAGE WAS IDENTIFIED TO BE DAMAGED. THERE WAS NO PATIENT INVOLVEMENT.

Description of Event or Problem · 0

NO FURTHER EVENT INFORMATION IS AVAILABLE AT THE TIME OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1037783 TPRLC 133 MP TYPE1 PPS SO 15.0 PROSTHESIS, HIPS KWA ZIMMER BIOMET, INC. N/A 6028582 00880304514379

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown SEE H11 NARRATIVE.