FDA Adverse Event Injury Summary report: N

2027971-2023-031790

MDR report key: 16140991 · Received January 11, 2023

Report

Report Number
2027971-2023-031790
Event Type
Injury
Date Received
January 11, 2023
Date of Event
December 6, 2022
Report Date
January 11, 2023
Manufacturer
NOBEL BIOCARE USA, LLC
Product Code
DZE
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
LH
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
909673 DZE NOBEL BIOCARE USA, LLC

Patients

Seq Age Sex Outcome Treatment
1 60 YR Male Required Intervention