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U.S. Department of Health and Human Services

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

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BIOMET 3I 3I T3 TAPERED IMPLANT 4/3 X 10MM; DENTAL IMPLANT Back to Search Results
Catalog Number BOPT4310
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Pain (1994)
Date of Event 04/07/2025
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient was scheduled for a two (2) week follow up after being prescribed antibiotics (augmentin) for 10 days due to the sinus fluid level and pain around the implant at tooth location #4.The symptoms were not resolved; therefore the implant was removed.
 
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).A4: weight unknown / not provided.The device will not be returned for analysis as it was discarded; however, an investigation of the reported event is in progress.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Additional Manufacturer Narrative
This report is being submitted to relay additional information and device evaluation.The following sections are being reported: b4: date of this report was updated.G3: date received by manufacturer was updated.G6: type of report was updated.H2: type of follow up was updated.H3: device evaluated by manufacturer was updated.H6: type of investigation codes were added: 4109, 4111 and 3331.H6: investigation findings code was added: 213.H6: investigation conclusions code was added: 4310.H10: narrative/data was updated.Zimvie did not receive the reported implant for evaluation.Visual inspection could not be performed.The investigation has been performed based on the available information using the item number, device history record (dhr) review, and risk management file (rmf).Dhr review was completed for the subject lot number.No deviations or non-conformances, which could have caused or contributed to the reported event, were noted as part of the dhr.Complaint history review was performed for the reported lot number for similar events and 1 other relevant complaint was identified.Based on the investigation and risk management file review, the most likely root cause determined from the investigation was inadequate treatment planning.Therefore, based on the available information, device malfunction was not established.Without device receipt, the reported event is non-verifiable.No further investigation or immediate capa / hhe/d escalation is required, as the complaint investigation did not confirm the products were nonconforming at the time of distribution, and no new failure mode, harm, or hazardous situation was identified through the investigation performed.
 
Event or Problem Description
No additional event information received at the time of this report.
 
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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 Key22529852
Report Number0001038806-2025-01717
Device Sequence Number15460883
Product Code DZE
UDI-Device Identifier00844868028468
UDI-Public(01)00844868028468(17)290705(10)2120015980
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
K122300
Exemption Number5645646
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2025
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) 09/25/2025
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 Other
Device Catalogue NumberBOPT4310
Device Lot Number2120015980
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer Not provided
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date07/17/2025
Supplement Report FDA Received Date09/25/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/06/2024
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient Age60 YR
Patient SexUnknown
Patient EthnicityNon Hispanic
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