BEUDAMED
    FDA Adverse Event Death Summary report: N

    NOBELREPLACE CC PMC RP 4.3X13MM

    MDR report key: 11040663 · Received December 18, 2020

    Report

    Report Number
    2027971-2020-60880
    Event Type
    Death
    Date Received
    December 18, 2020
    Date of Event
    December 1, 2020
    Report Date
    December 18, 2020
    Manufacturer
    NOBEL BIOCARE AB
    Product Code
    DZE
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    IMPLANT FAILED DUE TO A FAILURE TO OSSEOINTEGRATE.

    Description of Event or Problem · 1

    IMPLANT FAILED DUE TO A FAILURE TO OSSEOINTEGRATE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1503034 NOBELREPLACE CC PMC RP 4.3X13MM ENDOSSEOUS DENTAL IMPLANT DZE NOBEL BIOCARE AB

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR Death| R