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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMVIE US CORP LLC IMPL TAPERED SCR-V SBM 3. 7MM 3.5MM 8MM; DENTAL IMPLANT

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ZIMVIE US CORP LLC IMPL TAPERED SCR-V SBM 3. 7MM 3.5MM 8MM; DENTAL IMPLANT Back to Search Results
Catalog Number TSVB8
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/29/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).G4: premarket identification pma/510(k) #: k011028|k013227.
 
Event or Problem Description
It was reported that the implant crown had become detached.The implant collar and the prosthesis screw were found to be fractured; however, the screw was completely removed from the implant.Implant was fractured at the collar and removed from tooth site #27.This report refers to implant fracture event.
 
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).The following fields have been updated: b4: date of this report b5: describe event or problem g3: date received by manufacturer g6: type of report h1: type of reportable event h2: follow up type h3: device evaluated by manufacturer h6: adverse event problem.H11: additional narrative.Zimvie received one (1) tsvb8, (impl tapered scr-v sbm 3.7mm 3.5mm 8mm), for evaluation.Visual evaluation was performed; a fracture has been identified on the implants collar.Dhr review was completed for the subject lot number 1235029.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 1235029, for similar events and one other complaint was identified.Review completed utilizing keywords: ¿dental: functional: fracture: implant¿.Based on the investigation and risk management file review, the most likely root cause determined from the investigation was clinician selects implant that is unable to resist long-term occlusal loading.Therefore, based on the available information, a device malfunction did occur.The fracture has been identified on the collar.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.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.
 
Event or Problem Description
No further event information is available at the time of this report.
 
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Brand Name
IMPL TAPERED SCR-V SBM 3. 7MM 3.5MM 8MM
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 Key24727142
Report Number0001038806-2026-01687
Device Sequence Number9269727
Product Code DZE
UDI-Device Identifier00889024019546
UDI-Public(01)00889024019546(17)250122(10)1235029
Combination Product (Y/N)N
Initial Reporter CountrySP
PMA/510(K) Number
K061410
Exemption Number5645646
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2020
Device Explanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional
Initial Reporter Occupation Dentist
Type of Report Initial,Followup
Report Date (Section B) 05/13/2026
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 Expiration Date01/22/2025
Device Catalogue NumberTSVB8
Device Lot Number1235029
Was Device Available for Evaluation? No
Date Returned to Manufacturer03/11/2026
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 Date03/30/2026
Supplement Report FDA Received Date05/13/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/24/2020
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
Concomitant Medical Products
and Therapy/Usage Dates
UNKNOWN ZIMMER SCREW
Outcome Attributed to Adverse Event Required Intervention;
Patient Age51 YR
Patient SexUnknown
Patient EthnicityNon Hispanic
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