FDA Adverse Event Other Summary report: N

BIOHORIZONS PADHH

MDR report key: 1348716 · Received March 18, 2009

Report

Report Number
1060818-2009-00002
Event Type
Other
Date Received
March 18, 2009
Date of Event
February 24, 2009
Report Date
March 18, 2009
Manufacturer
BIOHORIZONS IMPLANT SYSTEMS, INC.
Product Code
DZI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
DENTIST

Narratives

Additional Manufacturer Narrative · 1

PRODUCT WAS RETURNED FOR EVAL. YIELDING OF THE LATCH INDICATED EXCESSIVE TORQUE HAD BEEN APPLIED TO THE PART. DEVICE HISTORY RECORD REVIEW DEMONSTRATED DEVICE MET DESIGN REQUIREMENT.

Description of Event or Problem · 1

A PART OF THE INTERNAL ABUTMENT-LEVEL DRIVER BROKE OFF IN THE ABUTMENT "RIGHT UNDERNEATH THE TIP." THE IMPLANT WAS REMOVED IN ORDER TO RETRIEVE THE BROKEN DRIVER TIP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BIOHORIZONS PADHH INTERNAL ABUTMENT-LEVEL DRIVER DZI BIOHORIZONS IMPLANT SYSTEMS, INC. PADHH 0801898

Patients

Seq Age Sex Outcome Treatment
1 Other