FDA Adverse Event Injury Summary report: N

EXTERNA UNIVERSAL PLATFORM IMPLANT

MDR report key: 19666520 · Received July 3, 2024

Report

Report Number
3004417597-2024-00013
Event Type
Injury
Date Received
July 3, 2024
Date of Event
October 1, 2020
Manufacturer
B.T.I. BIOTECHNOLOGY INSTITUTE S.L.
Product Code
DZE
UDI-DI
08435389815136
PMA / PMN Number
K151391
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE BATCH DOCUMENTATION IS CHECKED AND NO ANOMALIES ARE DETECTED. ANY MANUFACTURING FAULT IS RULED OUT. AFTER EXAMINATION OF THE IMPLANT, IT CAN BE VERIFIED THAT THE IMPLANT DOES NOT SHOW SIGNS OF MISUSE OR SIGNS OF MALFUNCTION THAT COULD HAVE CONTRIBUTED TO THE EVENT. HOWEVER, THERE IS A SMALL GAP BETWEEN THE IMPLANT AND THE COVER SCREW, AS WELL AS SIGNS OF INFECTION AROUND THIS AREA.

Description of Event or Problem · 0

THE CLINICIAN INDICATES THAT HE PLACED THE IMPLANT ON (B)(6) 2020 AND, DURING THE SECOND SURGERY (TWO MONTHS LATER) IT WAS OBSERVED THAT THE IMPLANT HAD NOT OSSEOINTEGRATED. PATIENT WITH A BONE QUALITY III. IN THE EVENT THE PATIENT EXPERIENCED: INFECTION AND PAIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
757219 EXTERNA UNIVERSAL PLATFORM IMPLANT DZE B.T.I. BIOTECHNOLOGY INSTITUTE S.L. IRPUCA3710 AH04383.Z 08435389815136

Patients

Seq Age Sex Outcome Treatment
1 45 YR Female Required Intervention