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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: JJGC S.A. GM Drive Implant,Ti,3.5X11.5; Endosseous Dental Implant
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JJGC S.A. GM Drive Implant,Ti,3.5X11.5; Endosseous Dental Implant Back to Search Results
Catalog Number 109.960
Medical Device Problem Code Failure to Osseointegrate (1863)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/28/2026
Type of Reportable Event Serious Injury
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Brand Name
GM Drive Implant,Ti,3.5X11.5
Common Device Name
Endosseous Dental Implant
Manufacturer (Section D)
JJGC S.A.
av. juscelino kubitschek de
oliveira, 3291 cic
curitiba PR 81270 -200
BR  81270-200
MDR Report Key50823933
Report Number0001222315-2026-002866
Device Sequence Number10218360
Product Code DZE
UDI-Device Identifier07899878024316
UDI-Public07899878024316
Combination Product (Y/N)N
Initial Reporter StateUT
Initial Reporter CountryUS
Summary Report (Y/N)N
Device Implanted Year2026
Device Explanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Importer
Initial Reporter Occupation Dentist
Type of Report Initial
Report Date (Section B) 09/18/2026
Report Date (Section F) 09/18/2026
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 Number109.960
Device Lot NumberMEPV5
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer08/25/2026
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Distributor Facility Aware Date09/18/2026
Device Age15 MO
Event Location Other
Date Report to Manufacturer08/25/2026
Initial Date Received by Manufacturer Not provided
Initial Report FDA Received Date09/18/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
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
Outcome Attributed to Adverse Event Required Intervention;
Patient Age48 YR
Patient SexMale
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