BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INTERNA UNIVERSAL PLATFORM IMPLANT CA

    MDR report key: 19728828 · Received July 12, 2024

    Report

    Report Number
    3004417597-2024-00021
    Event Type
    Injury
    Date Received
    July 12, 2024
    Date of Event
    October 29, 2020
    Manufacturer
    B.T.I. BIOTECHNOLOGY INSTITUTE S.L.
    Product Code
    DZE
    UDI-DI
    08435389812289
    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 CONFIRMS THAT WHEN EXAMINING THE IMPLANT, IT WAS OBSERVED THAT IT HAD NOT OSSEOINTEGRATED. PATIENT WITH A BONE QUALITY II. IN THE EVENT THE PATIENT EXPERIENCED: INFECTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    275298 INTERNA UNIVERSAL PLATFORM IMPLANT CA DZE B.T.I. BIOTECHNOLOGY INSTITUTE S.L. IIPUCA4085 AI03536.Z 08435389812289

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR Male Required Intervention