FDA Adverse Event Injury Summary report: N

PTERYFIT IMPLANT

MDR report key: 19246494 · Received May 6, 2024

Report

Report Number
3011390931-2024-00054
Event Type
Injury
Date Received
May 6, 2024
Report Date
May 6, 2024
Manufacturer
NORIS MEDICAL LTD
Product Code
DZE
UDI-DI
07290108817102
PMA / PMN Number
K140440
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

AN INVESTIGATION HAS BEEN COMPLETED, EVENTS RECOGNIZING THAT A DEFINITIVE ROOT CAUSE CANNOT BE IDENTIFIED DUE TO A WIDE RANGE OF MISSING EXTERNAL FACTORS (NON-DESIGN OR MANUFACTURING RELATED), INCLUDING MEDICAL CONDITIONS (E.G., DIABETES, POOR BONE QUALITY, ETC. ) / PATIENT HABITS (E.G., SMOKING), IMPLANT IMPLANTATION AND REMOVAL DATE, AND REASON FOR IMPLANT REMOVAL. THE DHR WAS REVIEWED FOR LOT#9000788, AND NO EVIDENCE WAS DISCOVERED TO INDICATE THAT A PRODUCT DEFECT OR NON-CONFORMITY CONTRIBUTED TO THE ISSUE. SHOULD ADDITIONAL INFORMATION BE RECEIVED WHICH INDICATES THAT THE DEVICE MAY HAVE CAUSED OR CONTRIBUTED TO THE EVENT, AN ADDITIONAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

UDI RELATED DATA QUALITY UPDATES ONLY.

Description of Event or Problem · 0

THE HEALTHCARE PROFESSIONAL REPORTS THAT NMAF4218 LOT#9000788 IMPLANT WAS INSERTED. THE IMPLANTATION AND REMOVAL DATES HAVE NOT BEEN PROVIDED. THE DEVICE WAS FORWARDED TO THE MANUFACTURER. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
763189 PTERYFIT IMPLANT PTERYFIT DENTAL IMPLANT DZE NORIS MEDICAL LTD NMAF4218 9000788 07290108817102

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown