FDA Adverse Event Malfunction Summary report: N

RETAINING 2.5MM HEX DRIVE R LONG

MDR report key: 16240150 · Received January 25, 2023

Report

Report Number
0002023141-2023-00287
Event Type
Malfunction
Date Received
January 25, 2023
Report Date
January 27, 2023
Manufacturer
ZIMMER DENTAL
Product Code
NDP
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE FOLLOWING SECTIONS HAVE BEEN UPDATED: B4: DATE OF THIS REPORT. D1: BRAND NAME . D4: CATALOG NUMBER. D4: LOT/SERIAL # . G3: DATE RECEIVED BY MANUFACTURER. G6: CHECKED "FOLLOW-UP". H2: CHECKED FOLLOW-UP TYPE. H4: DEVICE MANUFACTURER DATE . H10: ADDED MANUFACTURER NARRATIVE.

Additional Manufacturer Narrative · 0

ONE (1) IMPL TAPERED SCR-V HA 3.7 MM 3.5MM 8MM (TSVH8) & ONE (1) RETAINING 2.5MM HEX DRIVE R LONG (RHL2.5) WERE RETURNED FOR INVESTIGATION. VISUAL EVALUATION OF THE AS RETURNED PRODUCT IDENTIFIED SIGNS OF USE. FUNCTIONAL TESTING TO RECREATE THE REPORTED EVENT; VERIFIED THE RHL2.5 WAS STUCK AND WOULD NOT RELEASE FROM THE IMPLANT. THE RHL2.5 HEX MEASURED 2.5MM. THE DRIVER IS FOR PLACEMENT ONLY VIA THE FMT. (MISUSE.) A PRE-EXISTING CONDITION NOTED ON THE PER WAS UNKNOWN BONE DENSITY TYPE. THE REPORTED IMPLANT WAS LOCATED ON TOOTH # 30 (UNIVERSAL) AND WAS USED, PLACED AND REMOVED ON THE SAME DAY. THE LENGTH OF THE DRIVER USAGE IS UNKNOWN. THE CUSTOMER DID NOT PROVIDE ANY PICTURES OR X-RAYS. APPROPRIATE DOCUMENTATION WAS REVIEWED. DHR REVIEW WAS COMPLETED FOR THE SUBJECT LOT NUMBERS (1252605 & 0301747). IT WAS CONFIRMED THAT ALL OPERATIONS AND INSPECTIONS WERE EXECUTED AS PER APPLICABLE PROCEDURE. NO DEVIATIONS OR NON-CONFORMANCES, WHICH COULD HAVE CAUSED OR CONTRIBUTED TO THE REPORTED EVENT, WERE NOTED AS PART OF THE DHR. LOT NUMBERS WERE INSPECTED AND PASSED ALL ACCEPTANCE CRITERIA BY QA. COMPLAINT HISTORY REVIEW WAS PERFORMED FOR THE REPORTED LOT NUMBERS (1252605 & 0301747) FOR SIMILAR EVENTS AND NO OTHER COMPLAINT WAS IDENTIFIED. NOVEMBER POST MARKET TRENDING WAS REVIEWED AND THERE WERE NO ACTIONABLE EVENTS OR CORRECTIVE ACTIONS FOR THE REPORTED EVENT (DOES NOT DISENGAGE/RELEASE) OR PRODUCT (TSVH8 & RHL2.5). NO ACTIONABLE ITEMS HAVE BEEN TRIGGERED THAT WILL AFFECT COMPLAINT HANDLING ON OUR END FOR THIS MONTH. BASED ON THE AVAILABLE INFORMATION, DEVICES MALFUNCTION DID OCCUR AND THE REPORTED EVENT WAS CONFIRMED. HOWEVER, ZIMVIE HAS FOUND THAT THE ISSUE RAISED AND INVESTIGATED THROUGH THIS COMPLAINT IS RELATED TO AN UNINTENDED USE OF THE DEVICE PER IFU 8874 REV 5. THE 2.5MMD HEX DRIVERS (GEMLOCK DELIVERY SYSTEM) SHOULD BE USED TO DELIVER ALL TAPERED SCREW-VENT IMPLANTS VIA THE FIXTURE MOUNT/TRANSFER.

Additional Manufacturer Narrative · 0

ZIMMER BIOMET COMPLAINT NUMBER (B)(4). PATIENT WEIGHT UNKNOWN / NOT PROVIDED. DATE OF EVENT UNKNOWN / NOT PROVIDED. BRAND NAME UNKNOWN / NOT PROVIDED. LOT/SERIAL # UNKNOWN / NOT PROVIDED. DEVICE EXPIRATION DATE UNKNOWN / NOT PROVIDED. DEVICE UDI NUMBER UNKNOWN / NOT PROVIDED. EMAIL UNKNOWN / NOT PROVIDED. FIRST NAME UNKNOWN / NOT PROVIDED. LAST NAME UNKNOWN / NOT PROVIDED. PMA/510(K) NUMBER UNKNOWN / NOT PROVIDED. DEVICE MANUFACTURER DATE UNKNOWN / NOT PROVIDED.

Description of Event or Problem · 0

NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Description of Event or Problem · 0

NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Description of Event or Problem · 0

IT WAS REPORTED THAT IMPLANT WAS PLACED AND WHEN THE HEX TOOL WAS TRYING TO BE REMOVED AFTER USE, IT COULD NOT COME OUT OF THE IMPLANT. WE HAD TO REMOVE THE IMPLANT AND REPLACE WITH A LARGER DIAMETER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1060286 RETAINING 2.5MM HEX DRIVE R LONG IMPLANT PLACEMENT TOOL NDP ZIMMER DENTAL 0301747

Patients

Seq Age Sex Outcome Treatment
1 56 YR Male