FDA Adverse Event Injury Summary report: N

NOBELREPLACE CC NP 3.5X8MM

MDR report key: 12052360 · Received June 23, 2021

Report

Report Number
2027971-2021-84624
Event Type
Injury
Date Received
June 23, 2021
Date of Event
February 24, 2021
Manufacturer
NOBEL BIOCARE USA INC
Product Code
DZE
UDI-DI
7332747035773
PMA / PMN Number
K073142
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
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
945619 NOBELREPLACE CC NP 3.5X8MM ENDOSSEOUS DENTAL IMPLANT DZE NOBEL BIOCARE USA INC 13078079 7332747035773

Patients

Seq Age Sex Outcome Treatment
1 49 YR Required Intervention