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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMVIE US CORP LLC IMPL TAPERED SCR-V HA 3.7 MM 3.5MM 11.5MM; DENTAL IMPLANT

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ZIMVIE US CORP LLC IMPL TAPERED SCR-V HA 3.7 MM 3.5MM 11.5MM; DENTAL IMPLANT Back to Search Results
Catalog Number TSVH11
Medical Device Problem Code Component Missing (2306)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/20/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).G4: additional pma/510(k) number ¿ k013227.The device will not be returned for analysis; however, an investigation of the reported event is in progress.Once the investigation has been completed, a follow-up mdr will be submitted.
 
Event or Problem Description
It was reported that the packaging for the implant was empty.The procedure was completed using another device.
 
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, 4111, 3331 and 4111.H6: investigation findings code was added: 213.H6: investigation conclusions code was added: 4315.H10: narrative/data was updated.Zimvie received the reported device for evaluation.Visual evaluation of the as returned device identified the implant packaging / outer box in an opened condition.The sterile outer vial's tamper seal was seen broken, and its inner vial was missing / not returned.Therefore, the coob complaint and the condition of the product / packaging delivered to the customer is unknown / non-verifiable.Functional testing to recreate the reported event could not be performed due to the nature of the device and event.This complaint refers to the specific device being investigated for this complaint record.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 did not submit images for the reported event.Based on the investigation and risk management file review, the most likely root cause determined from the investigation is improper handling of devices/packaging outside of zimvie control.Therefore, based on the available information, a packaging malfunction could not be verified.The reported event/coob was non-verifiable since the condition of the product/packaging received by the customer was unknown / non-verifiable.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
IMPL TAPERED SCR-V HA 3.7 MM 3.5MM 11.5MM
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
mark  mashburn
4555 riverside drive
palm beach gardens, FL 33410
5619713230
MDR Report Key23781474
Report Number0001038806-2025-03778
Device Sequence Number21377008
Product Code DZE
UDI-Device Identifier00889024019577
UDI-Public(01)00889024019577(17)291028(10)1287264
Combination Product (Y/N)N
Initial Reporter StateNC
Initial Reporter CountryUS
PMA/510(K) Number
K061410
Exemption Number5645646
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 02/09/2026
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 NumberTSVH11
Device Lot Number1287264
Was Device Available for Evaluation? Device Returned to Manufacturer
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 Date12/11/2025
Supplement Report FDA Received Date02/09/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/29/2024
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 Age18 YR
Patient SexUnknown
Patient EthnicityNon Hispanic
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