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 |