FDA Adverse Event Malfunction Summary report: N

TPRLC XR MP T1 PPS 17X119MM

MDR report key: 21761425 · Received April 3, 2025

Report

Report Number
0001825034-2025-00969
Event Type
Malfunction
Date Received
April 3, 2025
Date of Event
March 11, 2025
Report Date
July 8, 2025
Manufacturer
ZIMMER BIOMET, INC.
Product Code
LPH
UDI-DI
00880304517363
PMA / PMN Number
K120030
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

(B)(4). D10: 51-107160 TPRLC 133 MP TYPE1 PPS HO 16.0 6866813. 51-104140 TPRLC 133 T1 PPS HO 14X148MM 7128209. 51-104130 TPRLC 133 T1 PPS HO 13X146MM 7130654. 51-106160 TPRLC 133 MP TYPE1 PPS SO 16.0 3777625. 51-108050 TPRLC 133 MP T1 PPS SO 5X95MM 6185618. 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 AND/OR CORRECTED INFORMATION. UPDATED: D9, G3, G6, H2, H3, H6, H10. VISUAL EVALUATION OF THE RETURNED PRODUCT/PROVIDED PHOTOS IDENTIFIED DAMAGE TO THE STERILE PACKAGING (POUCH). 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. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL REPORT WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING INSPECTION OF CIRCULATED ITEMS THAT THE STERILE PACKAGING WAS IDENTIFIED TO BE DAMAGED. THERE WAS NO PATIENT INVOLVEMENT. IT WAS REPORTED THAT NO FURTHER INFORMATION IS AVAILABLE.

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
731183 TPRLC XR MP T1 PPS 17X119MM PROSTHESIS, HIPS LPH ZIMMER BIOMET, INC. N/A 6893651 00880304517363

Patients

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