FDA Adverse Event Injury Summary report: N

PTERYFIT IMPLANT

MDR report key: 19444639 · Received June 2, 2024

Report

Report Number
3011390931-2024-00249
Event Type
Injury
Date Received
June 2, 2024
Date of Event
February 21, 2024
Report Date
June 2, 2024
Manufacturer
NORIS MEDICAL LTD
Product Code
DZE
UDI-DI
07290108817133
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

THE PROBABILITY OF A MANUFACTURING OR DESIGN DEFECT THAT MIGHT LEAD TO IMPLANT REPLACEMENT DUE TO A PATIENT'S ANATOMICAL DEFECT HAS BEEN NONEXISTENT. IF ADDITIONAL INFORMATION IS RECEIVED THAT INDICATES 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 THE NMAF4225 LOT# 9000649 IMPLANT WAS INSERTED IN THE PATIENT'S MOUTH IN (B)(6) 2024. THE IMPLANT WAS REMOVED DURING PLACEMENT DUE TO PTERYGOID SOFT BONE. THE DEVICE WAS FORWARDED TO THE MANUFACTURER. NO PATIENT-OPERATIVE OR POST-OPERATIVE COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2124480 PTERYFIT IMPLANT PTERYFIT DENTAL IMPLANT DZE NORIS MEDICAL LTD NMAF4225 9000649 07290108817133

Patients

Seq Age Sex Outcome Treatment
1 68 YR Unknown