FDA Adverse Event
Injury
Summary report: N
ELEMENT RC INICELL, PF 4.0, E 4.0, L11.0
MDR report key: 18629376
·
Received February 2, 2024
Report
- Report Number
- 3003184527-2024-00347
- Event Type
- Injury
- Date Received
- February 2, 2024
- Date of Event
- November 15, 2023
- Report Date
- January 8, 2024
- Manufacturer
- THOMMEN MEDICAL AG
- Product Code
- DZE
- UDI-DI
- 07640156471236
- PMA / PMN Number
- K090154
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- DE
- Reporter Occupation
- DENTIST
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
PRIMARY STABILITY NOT ACHIEVED. ANOTHER IMPLANT Ø HAS BEEN PLACED SUCCESSFULLY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 255572 | ELEMENT RC INICELL, PF 4.0, E 4.0, L11.0 | DENTAL IMPLANT | DZE | THOMMEN MEDICAL AG | 4.23.124 | 31077 | 07640156471236 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 69 YR | Female | Other |