FDA Adverse Event Injury Summary report: N

IMPL TAPERED SCR-V SBM 6M M 5.7MM 10MM

MDR report key: 24072532 · Received January 14, 2026

Report

Report Number
0001038806-2026-00226
Event Type
Injury
Date Received
January 14, 2026
Report Date
March 2, 2026
Manufacturer
ZIMVIE US CORP LLC
Product Code
DZE
UDI-DI
00889024019379
PMA / PMN Number
K061410
Removal / Correction Number
DATA ADDED
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDED 0001038806-2026-00224.

Additional Manufacturer Narrative · 0

ZIMVIE COMPLAINT NUMBER (B)(4). THE FOLLOWING FIELDS HAVE BEEN UPDATED: B4: DATE OF THIS REPORT. B5: DESCRIBE EVENT OR PROBLEM. D2. TYPE OF DEVICE. G3: DATE RECEIVED BY MANUFACTURER. G6: TYPE OF REPORT. H1: TYPE OF REPORTABLE EVENT. H2: FOLLOW UP TYPE. H4: DEVICE MANUFACTURER DATE. H10: ADDITIONAL NARRATIVE. THIS SUPPLEMENTAL REPORT IS SUBMITTED PER FDA EMAIL REQUEST IN ORDER TO SUBMIT PRODUCT CODE DZE

Additional Manufacturer Narrative · 0

ZIMVIE COMPLAINT NUMBER (B)(4). A4: PATIENT WEIGHT UNKNOWN / NOT PROVIDED . B3: DATE OF EVENT UNKNOWN / NOT PROVIDED . E1: LAST NAME UNKNOWN / NOT PROVIDED. G4: ADDITIONAL PMA/510(K) NUMBER K011028, K013227.

Description of Event or Problem · 0

WITH FDA

Description of Event or Problem · 0

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

Description of Event or Problem · 0

IT WAS REPORTED THAT THE IMPLANT AT TOOTH SITE #3 FRACTURED AND WAS REMOVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
132035 IMPL TAPERED SCR-V SBM 6M M 5.7MM 10MM DENTAL IMPLANT DZE ZIMVIE US CORP LLC 1240988 00889024019379

Patients

Seq Age Sex Outcome Treatment
1 59 YR Unknown Required Intervention