FDA Adverse Event Injury Summary report: N

2027971-2022-041535

MDR report key: 13537276 · Received February 15, 2022

Report

Report Number
2027971-2022-041535
Event Type
Injury
Date Received
February 15, 2022
Date of Event
January 31, 2022
Manufacturer
NOBEL BIOCARE USA, LLC
Product Code
DZE
PMA / PMN Number
K083205
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Description of Event or Problem · 0

IMPLANT FAILED DUE TO FAILURE OF OSSEOINTEGRATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1733871 DZE NOBEL BIOCARE USA, LLC

Patients

Seq Age Sex Outcome Treatment
1 Female Required Intervention