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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMVIE US CORP LLC IMP, TSV, 6.0, 11, MTXF, MG,HA; DENTAL IMPLANT

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ZIMVIE US CORP LLC IMP, TSV, 6.0, 11, MTXF, MG,HA; DENTAL IMPLANT Back to Search Results
Catalog Number TSVT6H11
Medical Device Problem Code Separation Failure (2547)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/16/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).A4: weight unknown / not provided.G4: additional pma/510(k) number ¿ k133339.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
It was reported that after placing the implant at tooth site #30, the clinician attempted to remove the mount but it would not come off.The clinician extracted the implant and replaced it with another implant.Subsequently, only by applying extremely strong force to both the implant body and the mount did the mount finally come off.
 
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 codes were added: 4109, 4111 and 3331.H6: investigation findings code was added: 213.H6: investigation conclusions code was added: 67.H10: narrative/data was updated.Zimvie received the reported implant for evaluation.Visual and functional evaluation was performed.The implant had signs of use and was attached to the bundled mount.The implant and mount disengaged as intended.Dhr review was completed for the subject lot number.No deviations or non-conformance's, 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 probably user caused.However, during functional testing the product functioned as intended, no problem found.Therefore, based on the available information, device malfunction did not occur.The mount was not observed to be stuck to the implant.It functioned as intended during functional testing.The reported even was unconfirmed.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
IMP, TSV, 6.0, 11, MTXF, MG,HA
Common Device Name
DENTAL IMPLANT
Manufacturer (Section D)
ZIMVIE US CORP LLC
4555 riverside drive
palm beach gardens FL 33410
Manufacturer (Section G)
ZIMVIE US CORP LLC
4555 riverside drive
palm beach gardens FL 33410
Manufacturer Contact
carlos  gordian-arroyo
4555 riverside drive
palm beach gardens, FL 33410
5619713230
MDR Report Key23423501
Report Number0001038806-2025-02814
Device Sequence Number9536414
Product Code DZE
UDI-Device Identifier00889024344259
UDI-Public(01)00889024344259(17)271103(10)1256037
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K101880
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,Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date (Section B) 01/15/2026
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 NumberTSVT6H11
Device Lot Number1256037
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
Initial Report FDA Received Date10/30/2025
Supplement Report FDA Received Date01/15/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/04/2022
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 Age67 YR
Patient SexUnknown
Patient EthnicityNon Hispanic
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