FDA Adverse Event Injury Summary report: N

ENDOPORE ABUTMENT

MDR report key: 1366523 · Received April 22, 2009

Report

Report Number
9681239-2009-00003
Event Type
Injury
Date Received
April 22, 2009
Report Date
March 23, 2009
Manufacturer
SYBRON IMPLANT SOLUTIONS CORP.
Product Code
NHA
PMA / PMN Number
K952434
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE REPORTER, FROM THE DENTAL LABORATORY, REPORTED THAT AN ENDOPORE ABUTMENT HAD FRACTURED. HOWEVER, HE DID NOT PROVIDE ANY SPECIFIC INFORMATION REGARDING THE CAUSE OF THE ABUTMENT FRACTURE. THE DENTAL LAB REPORTED THAT THE PATIENT'S IMPLANT IS FINE. NO EVALUATION WAS PERFORMED: THE PRODUCT HAS NOT BEEN RETURNED TO SYBRON IMPLANT SOLUTIONS CORP. FOR EVALUATION.

Description of Event or Problem · 1

IN 2009, A DENTAL LABORATORY REPORTED TO SYBRON IMPLANT SOLUTIONS CORP. THAT AN ABUTMENT HAD FRACTURED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDOPORE ABUTMENT ABUTMENT, IMPLANT, DENTAL, ENDOSSEOUS NHA SYBRON IMPLANT SOLUTIONS CORP.

Patients

Seq Age Sex Outcome Treatment
1 Other