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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER DENTAL IMPL SWISSPLUS OCTAGON 4. 1MM 12MM; DENTAL IMPLANT

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ZIMMER DENTAL IMPL SWISSPLUS OCTAGON 4. 1MM 12MM; DENTAL IMPLANT Back to Search Results
Catalog Number OPB12
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes Unspecified Infection (1930); Pain (1994)
Date of Event 09/10/2025
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).Multiple reports are being submitted for this event.A1: patient identifier unknown / not provided.G4: pma/510(k) number: k002188.A summary investigation has been completed for infection events identifying that a definitive root cause cannot be identified due to the wide range of external (non-design/ non-manufacturing related) factors potentially impacting the sterility of the implant and its environment.Should additional information be received which indicates that the device may have caused or contributed to the infection event, an additional report will be submitted.
 
Event or Problem Description
It was reported that the dental implant located in tooth site #24 failed due to infection.Antibiotic was prescribed and the doctor will wait for regeneration.The doctor reported pain.
 
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).Dhr review was completed for the subject lot number 63838188.No deviations or non-conformances, which could have caused or contributed to the reported event, were noted as part of the dhr.Sterilization record was reviewed and verified to have passed all sterilization activities with no issues or nonconformities identified.Complaint history review was performed for the reported lot number 63838188 for similar events and two (2) other complaints were identified.Review completed utilizing keywords: ¿infection¿ a summary investigation has been completed for infection events identifying that a definitive root cause cannot be identified due to the wide range of external (non-design/ non-manufacturing related) factors potentially impacting the sterility of the implant and its environment.Should additional information be received which indicates that the device may have caused or contributed to the infection event, an additional report will be submitted.
 
Event or Problem Description
No further event information is available at the time of this report.
 
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Brand Name
IMPL SWISSPLUS OCTAGON 4. 1MM 12MM
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
mark mashburn
4555 riverside drive
palm beach gardens, FL 33410
5619713230
MDR Report Key23358145
Report Number0001038806-2025-02614
Device Sequence Number8965500
Product Code DZE
UDI-Device Identifier00889024015807
UDI-Public(01)00889024015807(17)221130(10)63838188
Combination Product (Y/N)N
Initial Reporter CountrySP
PMA/510(K) Number
K011245
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,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 12/09/2025
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 Expiration Date11/30/2022
Device Catalogue NumberOPB12
Device Lot Number63838188
Was Device Available for Evaluation? No
Date Returned to Manufacturer10/01/2025
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 Date10/22/2025
Supplement Report FDA Received Date12/09/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/15/2017
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 Age58 YR
Patient SexUnknown
Patient EthnicityNon Hispanic
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