BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NOBELACTIVE INTERNAL NP 3.5X13MM

    MDR report key: 12011986 · Received June 16, 2021

    Report

    Report Number
    2027971-2021-82545
    Event Type
    Injury
    Date Received
    June 16, 2021
    Date of Event
    April 9, 2021
    Manufacturer
    NOBEL BIOCARE USA INC
    Product Code
    DZE
    UDI-DI
    7332747010602
    PMA / PMN Number
    K071370
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SP
    Reporter Occupation
    DENTIST

    Narratives

    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
    905853 NOBELACTIVE INTERNAL NP 3.5X13MM ENDOSSEOUS DENTAL IMPLANT DZE NOBEL BIOCARE USA INC 13087655 7332747010602

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Required Intervention