FDA Adverse Event
Injury
Summary report: N
NOBELREPLACE CC RP 5.0X11.5MM
MDR report key: 19037325
·
Received April 3, 2024
Report
- Report Number
- 9611993-2024-059156
- Event Type
- Injury
- Date Received
- April 3, 2024
- Date of Event
- March 7, 2024
- Manufacturer
- NOBEL BIOCARE AB
- Product Code
- DZE
- PMA / PMN Number
- K073142
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- RS
- Reporter Occupation
- DENTIST
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
IMPLANT FAILED DUE TO A FAILURE TO OSSEOINTEGRATE. 03.04.2024 15:15:10 CET (5023852). USER:5023852 RECEIVED DATE OF THE RETURN PRODUCT:03/04/2024.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1545097 | NOBELREPLACE CC RP 5.0X11.5MM | ENDOSSEOUS DENTAL IMPLANT | DZE | NOBEL BIOCARE AB |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 43 YR | Female | Required Intervention |