FDA Adverse Event
Injury
Summary report: N
SYBRONPRO XRT
MDR report key: 1935792
·
Received December 22, 2010
Report
- Report Number
- 2016150-2010-00214
- Event Type
- Injury
- Date Received
- December 22, 2010
- Report Date
- November 25, 2010
- Manufacturer
- EBI INC.
- Product Code
- DZE
- Adverse Event
- Yes
- Report Source
- Distributor report
- Reporter Location
- FR
- Reporter Occupation
- DENTIST
Narratives
Description of Event or Problem · 1
ON (B)(6), 2010 A DOCTOR REPORTED THAT A PATIENT LOST A SYBRONPRO XRT IMPLANT DUE TO PERI-IMPLANTITIS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | SYBRONPRO XRT | IMPLANT, ENDOSSEOUS, ROOT-FORM | DZE | EBI INC. | 081102 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 78 YR | Other| R |