BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INTERNA UNIVERSAL PLATFORM IMPLANT CA

    MDR report key: 19689439 · Received July 8, 2024

    Report

    Report Number
    3004417597-2024-00019
    Event Type
    Injury
    Date Received
    July 8, 2024
    Date of Event
    October 23, 2020
    Manufacturer
    B.T.I. BIOTECHNOLOGY INSTITUTE S.L.
    Product Code
    DZE
    UDI-DI
    08435389812203
    PMA / PMN Number
    K151391
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GM
    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.

    Description of Event or Problem · 0

    THE CLINICIAN INDICATES THAT HE PLACED THE IMPLANT ON (B)(6) 2020 AND TWO WEEKS LATER IT WAS NOTED THAT THE IMPLANT HAD NOT OSSEOINTEGRATED. PATIENT WITH BONE QUALITY II. IN THE EVENT THE PATIENT EXPERIENCED: INFECTION AND INFLAMMATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    834066 INTERNA UNIVERSAL PLATFORM IMPLANT CA DZE B.T.I. BIOTECHNOLOGY INSTITUTE S.L. IIPUCA4010 AI05332.Z 08435389812203

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Female Required Intervention