MAUDE Adverse Event Report: BIOMET 3I 3I T3® TAPERED IMPLANT 4/3 X 10MM; DENTAL IMPLANT

Catalog Number	BOPT4310
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes	Unspecified Infection (1930); Inflammation (1932); Osteolysis (2377)
Date of Event	07/23/2024
Type of Reportable Event	Serious Injury
Event or Problem Description
It was reported that the implant at tooth site #29 was removed due to peri-implantitis.Symptoms as a result of the event: inflammation and swelling.
Additional Manufacturer Narrative
Zimvie complaint number: (b)(4).A4: weight unknown / not provided.A summary investigation has been completed for peri-implantitis events recognizing that a definitive root cause cannot be identified due to a wide range of external factors (non-design or manufacturing related), including medical conditions (e.G., diabetes, poor bone quality, etc.) / patient habits (e.G., smoking) and surgical technique.Previously completed investigations for these events have not identified any signals indicating potential non-conformances affecting the manufacturing and sterilization processes.Furthermore, the probability of a manufacturing or design defect that might lead to peri-implantitis occurring and escaping the available detections has been assessed and found remote and almost non-existent.Should additional information be received which indicates that the device may have caused or contributed to the event, an additional report will be submitted.
Event or Problem Description
This report is being submitted to retract the initial report, mfr report number 0001038806-2025-00354 that was submitted on february 18, 2025, as this event had already been submitted and is a duplicate of mfr report number 0001038806-2025-00353 that was submitted on february 18, 2025.
Additional Manufacturer Narrative
This report is being submitted to relay corrected data and additional information.Correction: the initial report, mfr report number 0001038806-2025-00354 that was submitted on february 18, 2025 is a duplicate of mfr report number 0001038806-2025-00353.Therefore, this supplemental mw is being submitted as a retraction due to duplication of mfr report number 0001038806-2025-00353.All details associated with this event have been processed and completed under mfr report number 0001038806-2025-00353.Therefore, no additional reports will be submitted under mfr report number 0001038806-2025-00354.

• Brand Name: 3I T3® TAPERED IMPLANT 4/3 X 10MM
• Common Device Name: DENTAL IMPLANT
• Manufacturer (Section D): BIOMET 3I; 4555 riverside drive; palm beach gardens FL 33410
• Manufacturer (Section G): BIOMET 3I; 4555 riverside drive; palm beach gardens FL 33410
• Manufacturer Contact: carlos gordian-arroyo ; 4555 riverside drive; palm beach gardens, FL 33410 ; 5619713230
• MDR Report Key: 21392265
• Report Number: 0001038806-2025-00354
• Device Sequence Number: 12958627
• Product Code: DZE
• UDI-Device Identifier: 00844868028468
• UDI-Public: (01)00844868028468(17)281016(10)2120004449
• Combination Product (Y/N): N
• Initial Reporter State: AZ
• Initial Reporter Country: US
• PMA/510(K) Number: K122300
• Exemption Number: 5645646
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2024
• Device Explanted Year: 2024
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Health Professional,User Facility
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 03/20/2025

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Operator of Device: Lay User/Patient
• Device Catalogue Number: BOPT4310
• Device Lot Number: 2120004449
• Was Device Available for Evaluation?: Yes
• Date Returned to Manufacturer: 01/26/2025
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: Not provided
• Supplement Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 02/18/2025
• Supplement Report FDA Received Date: 03/21/2025
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 10/17/2023
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Age: 58 YR
• Patient Sex: Male
• Patient Ethnicity: Non Hispanic