FDA Adverse Event
Injury
Summary report: N
0001222315-2022-06867
MDR report key: 14055092
·
Received April 8, 2022
Report
- Report Number
- 0001222315-2022-06867
- Event Type
- Injury
- Date Received
- April 8, 2022
- Date of Event
- February 24, 2022
- Report Date
- April 8, 2022
- Manufacturer
- STRAUMANN MANUFACTURING, INC.
- Product Code
- DZE
- Adverse Event
- Yes
- Report Source
- Distributor report
- Reporter Location
- PA, US
- Reporter Occupation
- DENTIST
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
THE CLINICIAN REPORTS THE IMPLANT WAS INSERTED (B)(6) 2022 IN ADA 3. ON (B)(6) 2022, NON-OSSEOINTEGRATION WAS VERIFIED. THE DEVICE WAS FORWARDED TO THE MANUFACTURER. AT THE EVENT THE PATIENT EXPERIENCED: PERI-IMPLANTITIS AND ABSCESS. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 141707 | DZE | STRAUMANN MANUFACTURING, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 75 YR | Female | Required Intervention |