FDA Adverse Event Injury Summary report: N

NOBELPARALLEL CC NP 3.75X11.5MM

MDR report key: 12045534 · Received June 22, 2021

Report

Report Number
2027971-2021-84480
Event Type
Injury
Date Received
June 22, 2021
Date of Event
June 2, 2021
Manufacturer
NOBEL BIOCARE USA INC
Product Code
DZE
UDI-DI
7332747091458
PMA / PMN Number
K073142
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
937085 NOBELPARALLEL CC NP 3.75X11.5MM ENDOSSEOUS DENTAL IMPLANT DZE NOBEL BIOCARE USA INC 13107667 7332747091458

Patients

Seq Age Sex Outcome Treatment
1 64 YR Required Intervention