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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 Mechanical Problem (1384)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/30/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Zimvie received one (1) tmt4b10, (imp tm 4.1mm mtx full,10m for evaluation.Visual evaluation / functional test was performed, no malfunction discovered.Implant detached from mount as intended.Dhr review was completed for the subject lot number 1288774.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 1288774 for similar events and no other complaint was identified.The customer did not submit images for the reported event.A definitive root cause could not be determined since the device malfunction did not occur, and the reported event has been unconfirmed following functional testing and physical evaluation.Therefore, based on the available information, a device malfunction did not occur.Implant detached from mount as intended.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.The following sections have been updated: b4: date of this report.G3: date received by manufacturer.G6: checked "follow-up".H2: checked follow-up type.H3: changed "no" to "yes".H6: entered evaluation codes.H11: added manufacturer narrative.
 
Event or Problem Description
No further event information available at the time of this report.
 
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).G4: additional pma/510(k) number k113753, k112160.
 
Event or Problem Description
It was reported the implant for site 7, the mount will not disengage from implant.Placed a new implant in same procedure.
 
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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
mark mashburn
4555 riverside drive
palm beach gardens, FL 33410
5619713230
MDR Report Key24193623
Report Number0001038806-2026-00452
Device Sequence Number9599922
Product Code DZE
UDI-Device Identifier00889024018938
UDI-Public(01)00889024018938(17)291030(10)1288774
Combination Product (Y/N)N
Initial Reporter StateSC
Initial Reporter CountryUS
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 Health Professional,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 02/27/2026
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 NumberTMT4B10
Device Lot Number1288774
Was Device Available for Evaluation? No
Date Returned to Manufacturer01/15/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer Not provided
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date01/27/2026
Supplement Report FDA Received Date02/27/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/31/2024
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 Age47 YR
Patient SexUnknown
Patient EthnicityNon Hispanic
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