FDA Adverse Event Injury Summary report: N

2027971-2024-101291

MDR report key: 19734801 · Received July 12, 2024

Report

Report Number
2027971-2024-101291
Event Type
Injury
Date Received
July 12, 2024
Date of Event
June 3, 2024
Report Date
July 12, 2024
Manufacturer
NOBEL BIOCARE USA, LLC
Product Code
DZE
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
DA
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Description of Event or Problem · 0

IMPLANT FAILED DUE TO A LOSS OF OSSEOINTEGRATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
894458 DZE NOBEL BIOCARE USA, LLC

Patients

Seq Age Sex Outcome Treatment
1 62 YR Female Required Intervention