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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMVIE US CORP LLC IMP TM 4.1MM MTX FULL,10M; DENTAL IMPLANT

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ZIMVIE US CORP LLC IMP TM 4.1MM MTX FULL,10M; DENTAL IMPLANT Back to Search Results
Catalog Number TMT4B10
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/08/2025
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the implant at tooth site #16 had fractured during placement.An additional appointment was required.
 
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).A2: age and date of birth unknown / not provided.A3: patient sex unknown / not provided.A4: weight unknown / not provided.D4: lot number unknown / not provided.E1: email address and first/given name unknown / not provided.G4: additional pma/510(k) number ¿ k113753|k112160.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.
 
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 code was added: 4114, 4109, 3331 and 4111.H6: investigation findings code was added: 3252.H6: investigation conclusions code was added: 4307.H10: narrative/data was updated.Zimvie did not receive the complaint device 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-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.The customer submitted images for the reported event.The implant was fractured at the portion of the implant.Based on the investigation and risk management file review, the most likely root cause determined from the investigation was customer error, not following protocol for implant placement and final seating.Therefore, based on the available information and submitted images, a device malfunction was confirmed.Image evidence revealed the implant 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.
 
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.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 added: 10.H10: narrative/data was updated.Zimvie received the reported device for evaluation.Visual evaluation was performed, the implant has signs of use with debris on its external threads.The implant was fractured at the body.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.The customer submitted images for the reported event.The implant was fractured at the portion of the implant.Based on the investigation and risk management file review, the most likely root cause determined from the investigation was customer error, not following protocol for implant placement and final seating.Therefore, based on the available information and submitted images, 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.
 
Event or Problem Description
No additional event information received at the time of this report.
 
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Brand Name
IMP TM 4.1MM MTX FULL,10M
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 Key23440370
Report Number0001038806-2025-02880
Device Sequence Number8672762
Product Code DZE
UDI-Device Identifier00889024018938
UDI-Public(01)00889024018938(17)300219(10)1295669
Combination Product (Y/N)N
Initial Reporter CountryIN
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,User Facility,Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 03/23/2026
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 Catalogue NumberTMT4B10
Device Lot Number1295669
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 Date10/31/2025
Supplement Report FDA Received Date12/12/2025
03/23/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/20/2025
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 SexUnknown
Patient EthnicityNon Hispanic
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