FDA Adverse Event Injury Summary report: N

2027971-2022-042395

MDR report key: 13545570 · Received February 16, 2022

Report

Report Number
2027971-2022-042395
Event Type
Injury
Date Received
February 16, 2022
Date of Event
February 3, 2022
Report Date
February 16, 2022
Manufacturer
NOBEL BIOCARE USA, LLC
Product Code
DZE
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
SP
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
1390131 DZE NOBEL BIOCARE USA, LLC

Patients

Seq Age Sex Outcome Treatment
1 53 YR Male Required Intervention