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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER DENTAL ABUT CONTOUR 4.5X5.5 3 MM CUFF; DENTAL ABUTMENT

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ZIMMER DENTAL ABUT CONTOUR 4.5X5.5 3 MM CUFF; DENTAL ABUTMENT Back to Search Results
Catalog Number ZOA453S
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/02/2025
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that more than two years after restoration, the patient went to the hospital for review and found that the crown was loose.Examination showed that the abutment was broken and the implant was loose.The implant and abutment were removed.
 
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).Customer has indicated that the product is in process of being returned to zimvie for investigation.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event or Problem Description
No additional event information received at the time of this report.
 
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, 4114 and 3331.H6: investigation findings code was added: 213.H6: investigation conclusions code was added: 4315.H10: narrative/data was updated.Zimvie did not receive the reported abutment 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 no other complaint was identified.Based on the investigation and risk management file review, the most likely root cause determined from the investigation was patient factors.Therefore, based on the available information, device malfunction could not be verified.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 product was nonconforming at the time of distribution, and no new failure mode, harm, or hazardous situation was identified through the investigation performed.
 
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.D9: device availability and return date were 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 code was removed: 4114.H6: investigation conclusions code was added: 67.H10: narrative/data was updated.Zimvie received the reported abutment for evaluation.Visual inspection was performed.Returned abutment shows signs of wear and use.Reported fracture was not observed.Malfunction not identified.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 no other complaint was identified.Based on the investigation and risk management file review, the most likely root cause determined from the investigation was patient factors.However, during assessment, no problem was found with the returned abutment.Therefore, based on the available information, device malfunction could not be verified.Reported fracture was not observed and bundled screw was not returned for assessment.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 product was 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
ABUT CONTOUR 4.5X5.5 3 MM CUFF
Common Device Name
DENTAL ABUTMENT
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 Key22902274
Report Number0002023141-2025-02348
Device Sequence Number15453939
Product Code NHA
UDI-Device Identifier00889024020856
UDI-Public(01)00889024020856(17)221231(10)63890565
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K052600
Exemption Number5645646
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2022
Device Explanted Year2025
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 02/02/2026
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? Yes
Operator of Device Other
Device Expiration Date12/31/2022
Device Catalogue NumberZOA453S
Device Lot Number63890565
Was Device Available for Evaluation? Device Returned to Manufacturer
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer Not provided
Supplement Date Received by ManufacturerNot provided
Not provided
Initial Report FDA Received Date08/27/2025
Supplement Report FDA Received Date10/01/2025
02/02/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/19/2018
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
Concomitant Medical Products
and Therapy/Usage Dates
TSVWB10, IMPL TAPERED SCR-V SBM 4. 7MM 4.5MM 10MM.
Outcome Attributed to Adverse Event Required Intervention;
Patient Age56 YR
Patient SexUnknown
Patient EthnicityNon Hispanic
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