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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZimVie US Corp LLC IMP,TSV,3.7,13,MTX,MG; Dental Implant

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ZimVie US Corp LLC IMP,TSV,3.7,13,MTX,MG; Dental Implant Back to Search Results
Catalog Number TSVTB13
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 06/24/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that two implants were removed due to an infection and a bone loss.Tooth sites 23 and 26.
 
Additional Manufacturer Narrative
Zimvie complaint number (b)(4) a2: age at time of the event: unknown / not provided a4: patient weight: unknown / not provided d10: concomitant medical products: tsvtb13, imp,tsv,3.7,13,mtx,mg, lot: 63672161 a summary investigation has been completed for bone loss and infection 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 bone loss and infection have not identified any signals indicating potential non-conformances affecting the manufacturing and sterilization processes.Furthermore, the probability of manufacturing or design defects that might lead to bone loss 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
IMP,TSV,3.7,13,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
+1(561)971-3230
MDR Report Key50798908
Report Number0001038806-2026-04812
Device Sequence Number13405686
Product Code DZE
UDI-Device Identifier00889024019942
UDI-Public(01)00889024019942(17)220731(10)63672161
Combination Product (Y/N)N
Initial Reporter StatePA
Initial Reporter CountryUS
PMA/510(K) Number
K101977
Exemption Number5645646
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2018
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) 09/17/2026
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 Lay User/Patient
Device Expiration Date07/31/2022
Device Catalogue NumberTSVTB13
Device Lot Number63672161
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer08/25/2026
Is the Reporter a Health Professional? Yes
Initial Date Received by Manufacturer 08/25/2026
Initial Report FDA Received Date09/17/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/14/2017
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
Dental Implant See H11 Narrative
Outcome Attributed to Adverse Event Required Intervention;
Patient SexMale
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