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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZimVie US Corp LLC TSX IMPLANT, 3.7MMD, 11.5MML; Implant, Endosseous, Root-Form

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ZimVie US Corp LLC TSX IMPLANT, 3.7MMD, 11.5MML; Implant, Endosseous, Root-Form Back to Search Results
Catalog Number TSX37B11
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes Unspecified Infection (1930); Osteolysis (2377)
Date of Event 08/03/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the implant at tooth site #22 was removed due to peri-implantitis.During the uncovering appointment, movement of the implant was noted after placement of the healing abutment, and the implant was subsequently removed.
 
Additional Manufacturer Narrative
Zimvie complaint number (b)(4).A summary investigation has been completed for peri-implantitis events recognizing that a definitive root cause cannot be identified due to a wide range of external factors (non-design or manufacturing related), including medical conditions (e.G., diabetes, poor bone quality, etc.) / patient habits (e.G., smoking) and surgical technique.Previously completed investigations for these events have not identified any signals indicating potential non-conformances affecting the manufacturing and sterilization processes.Furthermore, the probability of a manufacturing or design defect that might lead to peri-implantitis occurring and escaping the available detections has been assessed and found remote and almost nonexistent.Should additional information be received which indicates that the device may have caused or contributed to the event, an additional report will be submitted.
 
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Brand Name
TSX IMPLANT, 3.7MMD, 11.5MML
Common Device Name
Implant, Endosseous, Root-Form
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
+1(561)971-3230
MDR Report Key50770261
Report Number0001038806-2026-04782
Device Sequence Number9717539
Product Code DZE
UDI-Device Identifier00844868045052
UDI-Public(01)00844868045052(17)300710(10)2120036103
Combination Product (Y/N)N
Initial Reporter StateLA
Initial Reporter CountryUS
PMA/510(K) Number
K220978
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
Initial Reporter Occupation Dentist
Type of Report Initial
Report Date (Section B) 09/15/2026
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? No
Operator of Device Health Professional
Device Catalogue NumberTSX37B11
Device Lot Number2120036103
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Received by Manufacturer 09/03/2026
Initial Report FDA Received Date09/15/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/11/2025
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 Unknown
Patient Sequence Number1
Patient Age39 YR
Patient SexMale
Patient Weight150 LB
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