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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOMET 3I CERTAIN¿ GOLD-TITE¿ HEXED SCREW; DENTAL SCREW

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BIOMET 3I CERTAIN¿ GOLD-TITE¿ HEXED SCREW; DENTAL SCREW Back to Search Results
Catalog Number IUNIHG
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/31/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).A2: age at time of the event: unknown / not provided.A4: patient weight: unknown / not provided.E1: reporter name: unknown / not provided.
 
Event or Problem Description
The doctor reports that the dental screw located in position number 46 failed because it fractured by the threads/tip.The doctor reports that the procedure was concluded by placing another screw.
 
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) iunihg, (certain gold-tite tm hexed screw)) for evaluation.Visual evaluation and a functional test were performed, the screw has signs of use and was fractured at the threads.Threaded piece was not returned.Device history record (dhr) review was completed for the subject lot number 1274161.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 1274161 for similar events and no other complaint was identified.Review completed utilizing keywords: dental: functional: fracture: screw.Based on the investigation and risk management file review, the most likely root cause determined from the investigation was customer error.Therefore, based on the available information, a device malfunction did occur.The screw was fractured.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
CERTAIN¿ GOLD-TITE¿ HEXED SCREW
Common Device Name
DENTAL SCREW
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 Key22903212
Report Number0001038806-2025-02031
Device Sequence Number15431448
Product Code NHA
UDI-Device Identifier00844868008538
UDI-Public(01)00844868008538(17)281129(10)1274161
Combination Product (Y/N)N
Initial Reporter CountrySP
PMA/510(K) Number
K072642
Exemption Number5645646
Number of Events Summarized1
Summary Report (Y/N)N
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) 10/16/2025
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 NumberIUNIHG
Device Lot Number1274161
Was Device Available for Evaluation? No
Date Returned to Manufacturer08/04/2025
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 Date08/27/2025
Supplement Report FDA Received Date10/16/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/01/2023
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 SexUnknown
Patient EthnicityNon Hispanic
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