FDA Adverse Event Malfunction Summary report: N

TPRLC XR MP FP T1 PPS 5X95MM T1

MDR report key: 9763345 · Received February 27, 2020

Report

Report Number
0001825034-2020-00890
Event Type
Malfunction
Date Received
February 27, 2020
Date of Event
February 12, 2020
Report Date
April 9, 2020
Manufacturer
ZIMMER BIOMET, INC.
Product Code
OQG
PMA / PMN Number
K120030
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. VISUAL EVALUATION OF THE RETURNED PRODUCTS IDENTIFIED THAT THERE IS DEBRIS INSIDE THE STERILE PACKAGING WHICH IS CONSISTENT WITH THE APPEARANCE OF FOAM DEBRIS FROM THE FOAM PACKAGING INSIDE THE STERILE BARRIER. THE COMPLAINT HAS BEEN CONFIRMED. REVIEW OF THE DEVICE HISTORY RECORDS IDENTIFIED NO DEVIATIONS OR ANOMALIES DURING MANUFACTURING RELATED TO THE REPORTED EVENT. THESE PRODUCTS WERE LIKELY CONFORMING WHEN THEY LEFT ZIMMER BIOMET CONTROL. THE ROOT CAUSE OF THE REPORTED ISSUE IS ATTRIBUTED TO TRANSIT DAMAGE CAUSING THE FOAM PACKAGING TO BECOME ABRADED AND SHED. THE EVENT IS BEING ADDRESSED THROUGH THE CAPA PROCESS. 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 IS AVAILABLE AT THE TIME OF THIS REPORT.

Additional Manufacturer Narrative · 1

(B)(4). CONCOMITANT MEDICAL PRODUCTS: TPRLC 133 T1 PPS HO, 13X146MM 6MM T1, CAT#51-104130, LOT# 3799301. TPRLC XR MP T1 PPS, 15X115MM 115MM T1, CAT#51-145150, LOT#3577454. TPRLC XR MP T1 PPS, 14X113MM 113MM T1, CAT# 51-145140, LOT# 3150390. TPRLC XR MP T1 PPS, 16X117MM 117MM T1, CAT# 51-145160, LOT# 2920949. TPRLC XR MP T1 PPS, 16X117MM 117MM T1, CAT#51-145160, LOT#3011809. REPORT SOURCE: (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: 0001825034-2020-00886, 0001825034-2020-00887, 0001825034-2020-00888, 0001825034-2020-00889, 0001825034-2020-00891.

Description of Event or Problem · 1

IT WAS REPORTED THAT DEBRIS WAS FOUND WITHIN STERILE PACKAGES. NO PATIENTS WERE INVOLVED. 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
226314 TPRLC XR MP FP T1 PPS 5X95MM T1 PROSTHESIS, HIP OQG ZIMMER BIOMET, INC. NI 3446162

Patients

Seq Age Sex Outcome Treatment
1 SEE H10