FDA Adverse Event Injury Summary report: N

REPLACE SELECT TAPERED PMC RP 4.3X16MM

MDR report key: 19365327 · Received May 21, 2024

Report

Report Number
2027971-2024-081214
Event Type
Injury
Date Received
May 21, 2024
Date of Event
March 29, 2024
Report Date
May 21, 2024
Manufacturer
NOBEL BIOCARE AB
Product Code
DZE
UDI-DI
07332747160895
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
RS
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Description of Event or Problem · 0

IMPLANT FAILED DUE TO A LOSS OF OSSEOINTEGRATION. 21.05.2024 15:31:53 CET (5023852). USER:5023852 RECEIVED DATE OF THE RETURN PRODUCT:21/05/2024.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
665040 REPLACE SELECT TAPERED PMC RP 4.3X16MM ENDOSSEOUS DENTAL IMPLANT DZE NOBEL BIOCARE AB 12148341 07332747160895

Patients

Seq Age Sex Outcome Treatment
1 42 YR Male Required Intervention