BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PEPGEN P-15 PUTTY

    MDR report key: 1032872 · Received April 23, 2008

    Report

    Report Number
    3006146445-2008-00035
    Event Type
    Injury
    Date Received
    April 23, 2008
    Date of Event
    December 3, 2007
    Report Date
    March 27, 2008
    Manufacturer
    DENTSPLY TULSA
    Product Code
    NPZ
    PMA / PMN Number
    P990033
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    DENTIST

    Narratives

    Additional Manufacturer Narrative · 1

    FAILURE OF BONE GRAFTS TO OSSEOINTEGRATE IS AN INHERENT RISK OF THE PROCEDURE, ALTHOUGH UNCOMMON. OTHER VARIABLES, BEYOND PROD NOT PERFORMING TO SPECIFICATIONS OR BEING NON-STERILE, TO CONSIDER IN A DIFFERENTIAL DIAGNOSIS WOULD BE PT HEALTH AND SOCIAL HISTORY (WHICH APPEAR TO BE UNREMARKABLE), SITE PREPARATION TRAUMA (HEAT OR PRESSURE) RESULTING IN NECROSIS OR SCARRING AND FIBROSIS, INSUFFICIENT PRIMARY STABILITY (SECONDARY TO BONE QUALITY AND/OR EXCESSIVE PREPARATION OF THE OSTEOTOMY AND QUANTITY OF MAXILLARY RIDGE BELOW THE MAXILLARY SINUS) OF THE IMPLANT RESULTING IN MICRO OR MACRO MOVEMENT AND SUBSEQUENT FIBROUS INTEGRATION, INDIVIDUAL GRAFTING TECHNIQUES, AND POST-OPERATIVE COMPLICATION (E.G. INFECTION). FROM THE INFO PROVIDED, IT IS NOT POSSIBLE TO DEFINITIVELY DETERMINE IF THE IMPLANT, GRAFT, TECHNIQUE, PT COMPLIANCE, POST - OPERATIVE COMPLICATION, ETC. WAS THE ETIOLOGY OF FAILURE. HOWEVER, BECAUSE A SECOND SURGERY WAS REQUIRED TO REMOVE AND/OR REPLACE THE IMPLANT AND GRAFT, THE IMPLANT LOSS WILL BE REPORTED VIA ASR, AS APPROPRIATE. A RETAINED SAMPLE WAS EVALUATED. RESULTS OF A BIOASSAY INDICATE THAT THE MATERIAL WAS IN SPECIFICATION. A DHR REVIEW WAS ALSO CONDUCTED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT PEPGEN P-15 PUTTY WAS USED WITH SIMULTANEOUS IMPLANT PLACEMENT IN THE RIGHT POSTERIOR MANDIBLE IN A PT WITH FAIR ORAL HYGIENE. THE OSTEOTOMY WAS PREPARED VIA DRILLING AND HEALING WAS SUBGINGIVAL. THE IMPLANT DID NOT OSSEOINTEGRATE AND INFECTION WAS NOTED UPON EXPLANTATION DURING THE HEALING PERIOD, APPROX SEVENTEEN WEEKS POST-PLACEMENT. IT IS NOT CLEAR IF THE GRAFT WAS INTEGRATING WITH THE SURROUNDING VITAL BONE OR IF IT ALSO FAILED WITH THE IMPLANT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PEPGEN P-15 PUTTY NPZ DENTSPLY TULSA NA 07PY146

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Required Intervention ANKYLOS A11 IMPLANT