FDA Adverse Event Injury Summary report: N

DENTAL LOCATOR

MDR report key: 16000351 · Received December 16, 2022

Report

Report Number
0001038806-2022-01920
Event Type
Injury
Date Received
December 16, 2022
Date of Event
November 1, 2022
Report Date
June 7, 2023
Manufacturer
BIOMET 3I
Product Code
NHA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ZIMMER BIOMET COMPLAINT NUMBER (B)(4). PATIENT WEIGHT UNKNOWN / NOT PROVIDED. BRAND NAME UNKNOWN / NOT PROVIDED. LOT/SERIAL # UNKNOWN / NOT PROVIDED. DEVICE EXPIRATION DATE UNKNOWN / NOT PROVIDED. DEVICE UDI NUMBER UNKNOWN / NOT PROVIDED. LAST NAME UNKNOWN / NOT PROVIDED. PMA/510(K) NUMBER UNKNOWN / NOT PROVIDED. DEVICE MANUFACTURER DATE UNKNOWN / NOT PROVIDED.

Additional Manufacturer Narrative · 0

ONE 3I T3 TAPERED IMPLANT 4/3 X 13MM (BOPT4313) AND AN UNKNOWN LOCATOR (MANUFACTURED BY: ZEST ANCHORS INC - SUPPLIER ID: (B)(4) WERE REPORTED FOR INVESTIGATION. BOPT4313 WAS NOT RETURNED. VISUAL EVALUATION OF RETURNED PRODUCTS IDENTIFIED A THIRD-PARTY IMPLANT WITH FRAGMENT OF AN UNKNOWN DEVICE INSIDE. THREE UNSUCCESSFUL ATTEMPTS WERE MADE TO CLARIFY THE EVENT AND ITEMS INVOLVED. SINCE NO INFORMATION IS KNOWN ABOUT COMPATIBILITY OF THE THIRD-PARTY IMPLANT AND THE LOCATOR, THE FRAGMENT COULD NOT BE IDENTIFIED/CONFIRMED AS LOCATOR¿S. HOWEVER, IN ORDER TO COMPLETE THIS INVESTIGATION, IT IS ASSUMED THAT THE THIRD-PARTY IMPLANT HAS BEEN MISTAKEN FOR BOPT4313 AND THE LOCATOR FRACTURED INSIDE THAT DEVICE. THE INVESTIGATION FOCUSES ONLY ON THE ZIMVIE IMPLANT AND THE RELATED/REPORTED EVENT. FUNCTIONAL TESTING COULD NOT BE PERFORMED DUE TO THE NATURE OF THE DEVICES AND EVENT. PRE-EXISTING CONDITION NOTED ON THE PER WAS DIABETES. THE DEVICES WERE INTENDED FOR TOOTH #4. X-RAY & PICTURE EVALUATION: NO X-RAY/PICTURE PROVIDED. APPROPRIATE DOCUMENTATION WAS REVIEWED. DHR REVIEW FOR THE LOT (2018021156) HAD REVEALED NO DEVIATIONS NOR NON-CONFORMANCES WHICH COULD HAVE CAUSED OR CONTRIBUTED TO THE REPORTED EVENT. ALL PRODUCTS WERE CONFORMING AT THE TIME THEY LEFT ZIMMER BIOMET. LOT WAS INSPECTED AND PASSED ALL ACCEPTANCE CRITERIA BY QA. COMPLAINT HISTORY REVIEW WAS PERFORMED FOR THE REPORTED LOT (2018021156) AND NO OTHER EVENT OR COMPLAINT WAS FOUND. FEBRUARY POST MARKET TRENDING WAS REVIEWED AND THERE WERE NO ACTIONABLE EVENTS OR CORRECTIVE ACTIONS FOR THE REPORTED EVENT OR PRODUCT. THEREFORE, BASED ON THE AVAILABLE INFORMATION, DEVICE MALFUNCTION COULD NOT BE VERIFIED FOR BOPT4313. HOWEVER, THE REPORTED EVENT (LOCATOR SCREW FRACTURE) WAS CONFIRMED.

Additional Manufacturer Narrative · 0

THE ZEST QUALITY ASSURANCE DEPARTMENT HAS CONDUCTED AN INVESTIGATION INTO THE PRODUCT EXPERIENCE REPORTED BY YOU WHICH INCLUDED THE BELOW ELEMENTS, AS INDICATED: LHR REVIEW: NO RESULTS ARE AVAILABLE SINCE NO ZEST LOT NUMBER WAS PROVIDED BY THE CUSTOMER. DATA REVIEW: A REVIEW OF OTHER ZEST PRODUCT EXPERIENCE FILES AND RELATED TRENDING DATA FOR SIMILAR INCIDENTS WAS PERFORMED TO EVALUATE WHETHER OTHER SIMILAR PRODUCT EXPERIENCES REPORTS HAVE BEEN RECEIVED AND IF DATA SUGGESTS ANY ADVERSE TRENDS MAY HAVE CONTRIBUTED TO THE PRODUCT EXPERIENCE ROOT CAUSE. RETURNED PRODUCT EVALUATION: NO PRODUCT WAS RETURNED (NPR) TO ZEST. ROOT-CAUSE OR MOST LIKELY ROOT-CAUSE CANNOT BE DETERMINED BASED UPON THE INFORMATION PROVIDED. THE REPORTED PRODUCT EXPERIENCE CONDITION CANNOT BE VERIFIED. NO PRODUCT WAS RETURNED, AND PHYSICAL EVALUATION CANNOT BE PERFORMED; THEREFORE, NO FINDINGS ARE AVAILABLE. ZEST WAS UNABLE TO FIND EVIDENCE OF A MANUFACTURING ISSUE PER CURRENT RECORDS AND BELIEVES THAT THE COMPONENTS DO NOT PRESENT ANY MANUFACTURER ERRORS. THE ISSUE IS BEING TRACKED AND TRENDED WITH NO FURTHER ACTIONS TAKEN AT THIS TIME.

Description of Event or Problem · 0

IT WAS REPORTED SCREW BROKEN INSIDE LOCATOR. TOOTH NUMBER 4.

Description of Event or Problem · 0

NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Description of Event or Problem · 0

NO FURTHER EVENT INFORMATION AVAILABLE AT THE TIME OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2747695 DENTAL LOCATOR NHA BIOMET 3I

Patients

Seq Age Sex Outcome Treatment
1 61 YR Female Required Intervention