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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMVIE US CORP LLC IMP,TSV,MCOL MG,4.7MM,10M; DENTAL IMPLANT

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ZIMVIE US CORP LLC IMP,TSV,MCOL MG,4.7MM,10M; DENTAL IMPLANT Back to Search Results
Catalog Number TSVMWB10
Medical Device Problem Code Unsealed Device Packaging (1444)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).G4: additional pma/510(k) number k101880.
 
Event or Problem Description
It was reported that the implant at tooth site #unk was not placed as the packaging was not sealed properly.Package is not properly sealed.The outer part of the packaging is not sealed properly (the lead is not tightly closed and the lock (the notches on the box) appears to have been defective.I discovered it today during implant placement.I do not feel comfortable placing this implant as not all packaging is intact.The procedure was completed with another implant.
 
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Brand Name
IMP,TSV,MCOL MG,4.7MM,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 Key25221858
Report Number0001038806-2026-02794
Device Sequence Number9810677
Product Code DZE
UDI-Device Identifier00889024019775
UDI-Public(01)00889024019775(17)271201(10)1260265
Combination Product (Y/N)N
Initial Reporter StateNY
Initial Reporter CountryUS
PMA/510(K) Number
K111889
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 Health Professional,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 05/19/2026
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 Lay User/Patient
Device Catalogue NumberTSVMWB10
Device Lot Number1260265
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer Not provided
Initial Report FDA Received Date05/19/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured12/02/2022
Is the Device Labeled for Single Use? (Y/N) Yes
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 Age18 YR
Patient SexFemale
Patient EthnicityNon Hispanic
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