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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER DENTAL IMP TM 4.1MM MTX,10MM; DENTAL IMPLANT

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ZIMMER DENTAL IMP TM 4.1MM MTX,10MM; DENTAL IMPLANT Back to Search Results
Catalog Number TMM4B10
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/12/2025
Type of Reportable Event Malfunction
Event or Problem Description
The doctor reports that the dental implant in position 25 failed due to a fracture at the apical third during the surgical procedure.The doctor reports that the procedure was concluded by placing another implant.The rest of the implant was removed from patient's mouth.
 
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).A4: patient weight unknown / not provided.G4: premarket identification k113753/k112160.
 
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).The following fields have been updated: b4: date of this report.B5: describe event or problem.G3: date received by manufacturer.G6: type of report.H1: type of reportable event.H2: follow up type.H3: device evaluated by manufacturer.H6: adverse event problem.H10: additional narrative.Zimvie received one (1) tmm4b10, (imp tm 4.1mm mtx,10mm) for evaluation.Visual evaluation was performed, the implant had signs of use.The implant was fractured at the body.The fractured piece was not returned.Dhr review was completed for the subject lot number 1273166.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 1273166 for similar events and no other complaint was identified.Review completed utilizing keywords: ¿dental : functional : fracture : implant¿ based on the investigation and risk management file review, the most likely root cause determined from the investigation was customer error - recommended protocol was followed during placement/seating.Therefore, based on the available information, a device malfunction did occur.The implant was fractured at the body.The reported event was confirmed.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.At this time, the complaint investigation has been completed and the record will be closed.If additional information is received, the record will be re-opened for further evaluation.
 
Event or Problem Description
No further event information is available at the time of this report.
 
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Brand Name
IMP TM 4.1MM MTX,10MM
Common Device Name
DENTAL IMPLANT
Manufacturer (Section D)
ZIMMER DENTAL
4555 riverside drive
palm beach gardens FL 33410
Manufacturer (Section G)
ZIMMER DENTAL
4555 riverside drive
palm beach gardens FL 33410
Manufacturer Contact
carlos gordian-arroyo
4555 riverside drive
palm beach gardens, FL 33410
5619713230
MDR Report Key22881911
Report Number0002023141-2025-02320
Device Sequence Number8861086
Product Code DZE
UDI-Device Identifier00889024018808
UDI-Public(01)00889024018808(17)281119(10)1273166
Combination Product (Y/N)N
Initial Reporter CountrySP
PMA/510(K) Number
K132258
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 Foreign,Health Professional
Initial Reporter Occupation Dentist
Type of Report Initial,Followup
Report Date (Section B) 10/15/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Other
Device Catalogue NumberTMM4B10
Device Lot Number1273166
Was Device Available for Evaluation? No
Date Returned to Manufacturer08/01/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer Not provided
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date08/25/2025
Supplement Report FDA Received Date10/15/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/21/2023
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
Patient Age56 YR
Patient SexUnknown
Patient EthnicityNon Hispanic
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