FDA Adverse Event Injury Summary report: N

EO IMPL., Ø 3.3 / 3.5MM, SLA 5.0MM

MDR report key: 12773595 · Received November 8, 2021

Report

Report Number
0009613348-2021-86431
Event Type
Injury
Date Received
November 8, 2021
Date of Event
October 4, 2021
Report Date
November 8, 2021
Manufacturer
INSTITUT STRAUMANN AG
Product Code
KCZ
UDI-DI
07630031718198
PMA / PMN Number
K990458
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE BATCH NUMBER COULD BE VERIFIED. OUR MANUFACTURING Q-SYSTEM ASSURES, THAT PRODUCTION AND PROCESS CONTROLS ARE IN PLACE TO ENSURE THAT BATCHES CONFIRM TO THE APPLICABLE SPECIFICATIONS BEFORE THEY ARE DISTRIBUTED. THE LOSS OF AN ENDOSSEOUS DENTAL IMPLANT AFTER SUCCESSFUL OSSEOINTEGRATION AND RESTORATION IS A KNOWN INHERENT RISK OF THE PROCEDURE. IMPLANTS MAY HAVE TO BE REMOVED IN CASE ONE OR MORE OF THE IMPLANT SUCCESS CRITERIA ARE NOT MET. IMPLANT SUCCESS CRITERIA ACCORDING TO BUSER ET AL. (1991) ARE: ABSENCE OF PERSISTENT SUBJECTIVE COMPLAINTS SUCH AS PAIN, FOREIGN BODY SENSATION AND /OR DYSESTHESIA. ABSENCE OF A RECURRENT PERI-IMPLANT INFECTION WITH SUPPURATION. ABSENCE OF IMPLANT MOBILITY. ABSENCE OF A CONTINUOUS RADIOLUCENCY AROUND THE IMPLANT. THE MANUFACTURER'S TREND ANALYSIS CONFIRMS THAT THE REPORTED FAILURE RATE ASSOCIATED WITH ITS DENTAL IMPLANTS IS BELOW THE EXPECTED FAILURE RATE FOR THIS TREATMENT AS PUBLISHED IN THE SCIENTIFIC LITERATURE.

Description of Event or Problem · 0

THE CLINICIAN REPORTS THE IMPLANT WAS INSERTED (B)(6) 2013 IN THE PATIENT'S MOUTH. ON (B)(6) 2021, LOSS OF OSSEOINTEGRATION WAS VERIFIED. THE DEVICE WAS FORWARDED TO THE MANUFACTURER. AT THE EVENT THE PATIENT EXPERIENCED: MOBILITY. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1673166 EO IMPL., Ø 3.3 / 3.5MM, SLA 5.0MM ENDOSSEOUS DENTAL IMPLANT KCZ INSTITUT STRAUMANN AG ET335 07630031718198

Patients

Seq Age Sex Outcome Treatment
1 Male Required Intervention