FDA Adverse Event Injury Summary report: N

IMPL TAPERED SCR-V SBM 4. 7MM 4.5MM 8MM

MDR report key: 25152679 · Received May 12, 2026

Report

Report Number
0001038806-2026-02613
Event Type
Injury
Date Received
May 12, 2026
Date of Event
April 16, 2026
Report Date
May 11, 2026
Manufacturer
ZIMVIE US CORP LLC
Product Code
DZE
UDI-DI
00889024020085
PMA / PMN Number
K061410
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CS
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ZIMVIE COMPLAINT NUMBER (B)(4). A4: PATIENT WEIGHT UNKNOWN / NOT PROVIDED. G4: ADDITIONAL PMA/510(K) NUMBER K011028, K013227.

Description of Event or Problem · 0

IT WAS REPORTED THAT IMPLANT WAS REMOVED DUE TO PERI-IMPLANTITIS. TOOTH SITE # 26.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
182638 IMPL TAPERED SCR-V SBM 4. 7MM 4.5MM 8MM Implant, endosseous, root-form DZE ZIMVIE US CORP LLC 1276935 00889024020085

Patients

Seq Age Sex Outcome Treatment
1