FDA Adverse Event Malfunction Summary report: N

TLOC 133 MP SP T1 PPSHO 6X97.5

MDR report key: 21739681 · Received April 1, 2025

Report

Report Number
0001825034-2025-00933
Event Type
Malfunction
Date Received
April 1, 2025
Date of Event
March 7, 2025
Report Date
June 26, 2025
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWA
UDI-DI
00880304512993
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: 51-104110; ITEM NAME TPRLC 133 T1 PPS HO 11X142MM LOT # 6636408. 51-145150; ITEM NAME TPRLC XR MP T1 PPS 15X115MM LOT # 6041831. 51-107170; ITEM NAME TPRLC 133 MP TYPE1 PPS HO 17.0 LOT # 7269926. 51-100040; ITEM NAME TPRLC 133 FP TYPE1 PPS SO 4.0 LOT # 7247907. 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

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. THE FOLLOWING SECTIONS WERE UPDATED: B4; D9; G3; H2; H3; H6; H10. PRODUCT RETURNED AND EVALUATED. VISUAL EVALUATION OF THE RETURNED PRODUCT/PROVIDED PHOTOS IDENTIFIED DAMAGE TO THE STERILE PACKAGING (POUCH). STERILITY HAD 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 WHILE INSPECTING THE PACKAGING, IT WAS FOUND WITH INNER PACKAGE WAS DAMAGE. THERE WAS NO PATIENT INVOLVEMENT. THERE IS NO FURTHER INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

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
1010747 TLOC 133 MP SP T1 PPSHO 6X97.5 PROSTHESIS, HIP KWA ZIMMER BIOMET, INC. 7183064 00880304512993

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown