MAUDE MDR 9887694

MDR report key
9887694
Report number
0002023141-2020-00646
Event key
0
Event type
3
Date of event
2019-12-20
Date received
2020-03-27
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS SUSANNE TAYLOR
Address
4555 RIVERSIDE DRIVE PALM BEACH GARDENS FL 33410 US
Phone
561-561-5617
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1HEAL COLLAR 3.5X3.5, 5MMHEALING ABUTMENTZIMMER DENTALNHAHC335N R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-270

Event Narratives#

N

Patient 1

ZIMMER BIOMET COMPLAINT (B)(4). PATIENT AGE IS NOT PROVIDED / UNKNOWN. PATIENT WEIGHT IS NOT PROVIDED / UNKNOWN. LOT NUMBER IS NOT PROVIDED / UNKNOWN. INITIAL REPORTER?S TITLE AND LAST NAME ARE NOT PROVIDED / UNKNOWN. THE REPORTED DEVICE WAS RECEIVED FOR EVALUATION. THE REPORTED CONDITION OF HEALING COLLAR COULD NOT SEAT IN IMPLANT WAS NOT CONFIRMED. VISUAL INSPECTION OF THE AS RETURNED PRODUCT IDENTIFIED SIGNS OF WEAR ABOUT THE HEALING COLLAR BODY AND THREADS. FUNCTIONAL TESTING WAS PERFORMED FOR THE RETURNED PRODUCT AND IT WAS DETERMINED THAT THE HEALING COLLAR SEATS AS NORMAL WITH A MATING IMPLANT. DHR REVIEW COULD NOT BE PERFORMED, AS THE LOT NUMBER ASSOCIATED WITH THE REPORTED PRODUCT IS NOT AVAILABLE. ZIMMER BIOMET QUALITY MANAGEMENT SYSTEM (QMS) HAS CONTROLS IN PLACE TO ENSURE THE DISTRIBUTION OF CONFORMING PRODUCT WITHIN SPECIFICATIONS. A COMPLAINT HISTORY REVIEW BY ITEM NUMBER WAS CONDUCTED DATING BACK TO 12 MONTHS FROM NOW. THE COMPLAINT HISTORY REVIEW REVEALED THAT THERE ARE NO EXISTING NON CONFORMANCES/CAPA/HHE/D/IE/PRODUCT HOLDS FOR THE REPORTED PRODUCT. A DEFINITIVE ROOT CAUSE FOR THE REPORTED EVENT COULD NOT BE DETERMINED. IF ANY FURTHER INFORMATION IS FOUND WHICH WOULD CHANGE OR ALTER ANY CONCLUSIONS OR INFORMATION, A SUPPLEMENTAL REPORT WILL BE FILED ACCORDINGLY. ZIMMER BIOMET WILL CONTINUE TO MONITOR FOR TRENDS.

D

Patient 1

DOCTOR REPORTS THAT HEALING CAP HC335 WAS NOT ABLE TO BE SEATED INTO THE IMPLANT AT TOOTH SITE #27.