FDA Adverse Event Malfunction Summary report: N

TPRLC 133 MP TYPE1 PPS SO 20.0 1

MDR report key: 9292775 · Received November 7, 2019

Report

Report Number
0001825034-2019-05063
Event Type
Malfunction
Date Received
November 7, 2019
Date of Event
October 21, 2019
Report Date
February 28, 2020
Manufacturer
ZIMMER BIOMET, INC.
Product Code
KWA
PMA / PMN Number
K110400
Removal / Correction Number
N/A
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. D4: UDI#: (B)(4). THE EVENT IS CONFIRMED WITH PRODUCT RECEIVED. VISUAL INSPECTION OF ALL RETURNED UNITS IDENTIFIED WHITE FOAM DEBRIS THAT WAS SEPARATED FROM THE FOAM PADDING WITHIN THE SEALED STERILE CAVITIES. THE STERILE SEALS REMAIN INTACT. DHR WAS REVIEWED AND NO DISCREPANCIES RELEVANT TO THE REPORTED EVENT WERE FOUND. THE LIKELY CONDITION OF THE PRODUCT WHEN LEAVING ZIMMER BIOMET WAS CONFORMING TO SPECIFICATIONS. THE ROOT CAUSE OF THE REPORTED ISSUE IS ATTRIBUTED TO TRANSIT DAMAGE. A CORRECTIVE ACTION WAS OPENED TO ASSESS ALL CURRENT STERILE BARRIER SYSTEMS USED TO PACKAGE PRODUCTS AT ZIMMER BIOMET BRIDGEND. AS PART OF THIS ACTION, THE POUCH IS BEING IMPROVED TO USE A STRONGER MATERIAL (NYLON), AND FOAM END CAPS ARE BEING ADDED. ALSO, THE ORIENTATION THE DEVICES ARE PACKED IN THE SHIPPER BOX IS MOVING FROM VERTICAL TO HORIZONTAL, AND THE THICKNESS OF THE SHIPPER BOX HAS BEEN INCREASED. 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

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

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: CATALOG#: 51-107130, TPRLC 133 MP TYPE1 PPS HO 13.0 M T1, LOT#: 6012740. CATALOG#: 51-100080, TPRLC 133 FP TYPE1 PPS SO 8.0, LOT#: 3508714. CATALOG#: 51-103160, TPRLC 133 T1 PPS SO 16X152MM T1, LOT#: 3920869. CATALOG#: 51-104150, TPRLC 133 T1 PPS HO 15X150MM 0MM T1, LOT#: 3838103. CATALOG#: 51-145160, TPRLC XR MP T1 PPS 16X117MM 117MM T1, LOT#: 6137915. CATALOG#: 51-105140, TPRLC XR T1 PPS 14X148MM MM T1, LOT#: 3856301. CATALOG#: 51-105160, TPRLC XR T1 PPS 16X152MM MM T1, LOT#: 3861572. CATALOG#: 51-106150, TPRLC 133 MP TYPE1 PPS SO 15.0 1, LOT#: 6121851. REPORT SOURCE: FOREIGN: (B)(6). 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. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 0001825034-2019-05051, 0001825034-2019-05053, 0001825034-2019-05055, 0001825034-2019-05056, 0001825034-2019-05058, 0001825034-2019-05059, 0001825034-2019-05061, 0001825034-2019-05062.

Description of Event or Problem · 1

IT WAS REPORTED THAT UPON INCOMING INSPECTION THERE WAS DEBRIS IN THE STERILE PACKAGING. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1087446 TPRLC 133 MP TYPE1 PPS SO 20.0 1 PROSTHESIS, HIP KWA ZIMMER BIOMET, INC. N/A 3832675

Patients

Seq Age Sex Outcome Treatment
1