FDA Adverse Event
Injury
Summary report: N
SYBRONPRO TL
MDR report key: 1792248
·
Received August 10, 2010
Report
- Report Number
- 2016150-2010-00114
- Event Type
- Injury
- Date Received
- August 10, 2010
- Report Date
- July 12, 2010
- Manufacturer
- EBI INC.
- Product Code
- DZE
- Adverse Event
- Yes
- Report Source
- Distributor report
- Reporter Location
- WA, US
- Reporter Occupation
- DENTIST
Narratives
Description of Event or Problem · 1
ON JULY 12, 2010, A DOCTOR REPORTED THAT A PATIENT LOST A SYBRONPRO TL IMPLANT DUE TO UNKNOWN CAUSES. THIS IS THE SECOND OF SEVEN REPORTS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | SYBRONPRO TL | IMPLANT, ENDOSSEOUS, ROOT-FORM | DZE | EBI INC. | 094016 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other| R |