FDA Adverse Event Injury Summary report: N

NOBELPARALLEL CC NP 3.75X15MM

MDR report key: 10496773 · Received September 4, 2020

Report

Report Number
2027971-2020-32894
Event Type
Injury
Date Received
September 4, 2020
Date of Event
January 18, 2019
Report Date
September 4, 2020
Manufacturer
NOBEL BIOCARE AB
Product Code
DZE
UDI-DI
7332747091472
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
CA
Reporter Occupation
DENTIST

Narratives

Description of Event or Problem · 1

IMPLANT FAILED DUE TO FAILURE OF OSSEOINTEGRATION. 04.09.2020 21:03:41 CET (B)(6). USER: (B)(6) RECEIVED DATE OF THE RETURN PRODUCT: 04/09/2020.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
960677 NOBELPARALLEL CC NP 3.75X15MM ENDOSSEOUS DENTAL IMPLANT DZE NOBEL BIOCARE AB 12096801 7332747091472

Patients

Seq Age Sex Outcome Treatment
1 58 YR Required Intervention