FDA Adverse Event Injury Summary report: N

2027971-2022-040094

MDR report key: 13508776 · Received February 10, 2022

Report

Report Number
2027971-2022-040094
Event Type
Injury
Date Received
February 10, 2022
Date of Event
February 9, 2022
Report Date
February 10, 2022
Manufacturer
NOBEL BIOCARE USA, LLC
Product Code
DZE
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
TU
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Description of Event or Problem · 0

IMPLANT FAILED DUE TO A FAILURE TO OSSEOINTEGRATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
80632 DZE NOBEL BIOCARE USA, LLC

Patients

Seq Age Sex Outcome Treatment
1 52 YR Female Required Intervention