FDA Adverse Event
Malfunction
Summary report: N
CERTAIN GOLD-TITE LARGE HEXED SCREW
MDR report key: 25064990
·
Received May 4, 2026
Report
- Report Number
- 0001038806-2026-02427
- Event Type
- Malfunction
- Date Received
- May 4, 2026
- Date of Event
- August 29, 2024
- Report Date
- May 4, 2026
- Manufacturer
- ZIMVIE US CORP LLC
- Product Code
- DZE
- UDI-DI
- 00844868006121
- PMA / PMN Number
- K972444
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PO
- Reporter Occupation
- DENTIST
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
ZIMVIE COMPLAINT NUMBER (B)(4) A4: PATIENT WEIGHT UNKNOWN / NOT PROVIDED D10. CONCOMITANT MEDICAL PRODUCTS IUNIHG, CERTAIN GOLD-TITE HEXED SCREW LOT 1280761 ILRGHG, CERTAIN GOLD-TITE LARGE HEXED SCREW LOT 1196425 G4: PREMARKET IDENTIFICATION K072642.
Description of Event or Problem · 0
IT WAS REPORTED A FRACTURE OF THREE OF THE PROSTHETIC SCREWS AT THE THREADED PART IN A PATIENT WITH A MANDIBULAR HYBRID PROSTHESIS ON FOUR IMPLANTS (TOOTH SITE 32,34,42,44), SO IT WAS DECIDED TO REPLACE ALL OF THEM, TAKING INTO ACCOUNT THE POSSIBLE OCLUSAL OVERLOAD. PATIENT SUFFERED PROSTHESIS MOBILITY AND INFLAMMATION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 30924 | CERTAIN GOLD-TITE LARGE HEXED SCREW | DENTAL SCREW | DZE | ZIMVIE US CORP LLC | 1250285 | 00844868006121 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |