FDA Adverse Event Injury Summary report: N

OSSEOSPEED TX 4.5 - 9 MM

MDR report key: 11840564 · Received May 18, 2021

Report

Report Number
9612468-2021-46676
Event Type
Injury
Date Received
May 18, 2021
Date of Event
January 7, 2021
Report Date
May 18, 2021
Manufacturer
DENTSPLY IMPLANTS (A DIVISION OF DENTSPLY IH AB)
Product Code
DZE
PMA / PMN Number
K053384
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
DENTIST

Narratives

Additional Manufacturer Narrative · 1

THEREFORE, BECAUSE A SERIOUS INJURY RESULTED, THIS EVENT IS REPORTABLE PER 21 CFR PART 803. THE DEVICE WAS NOT EVALUATED BECAUSE THE ISSUE IS A KNOWN INHERENT RISK OF THE DEVICE. WE WILL CONTINUE TO TRACK AND MONITOR THE TREND.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT EXPERIENCED A DENTAL IMPLANT LOSS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
736095 OSSEOSPEED TX 4.5 - 9 MM IMPLANT, ENDOSSEOUS, ROOT-FORM DZE DENTSPLY IMPLANTS (A DIVISION OF DENTSPLY IH AB) NA 148405

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention