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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMVIE US CORP LLC IMP,TSV,3.7,8,MTX,MG; DENTAL IMPLANT

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ZIMVIE US CORP LLC IMP,TSV,3.7,8,MTX,MG; DENTAL IMPLANT Back to Search Results
Catalog Number TSVTB8
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/12/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).
 
Event or Problem Description
It was reported that during the implant placement, it was identified that the implant has a small fisure at the hex.Tooth location 36.Other implant placed.
 
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Brand Name
IMP,TSV,3.7,8,MTX,MG
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 Key24851269
Report Number0001038806-2026-01937
Device Sequence Number8947222
Product Code DZE
UDI-Device Identifier00889024019966
UDI-Public(01)00889024019966(17)300617(10)1299180
Combination Product (Y/N)N
Initial Reporter CountrySP
PMA/510(K) Number
K101977
Exemption Number5645646
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
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) 05/22/2026
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 NumberTSVTB8
Device Lot Number1299180
Was Device Available for Evaluation? No
Date Returned to Manufacturer03/24/2026
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 Date04/11/2026
Supplement Report FDA Received Date05/22/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/18/2025
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 Initial
Patient Sequence Number1
Patient Age48 YR
Patient SexUnknown
Patient EthnicityNon Hispanic
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