FDA Adverse Event Injury Summary report: N

INTERNA NARROW PLATFORM IMPLANT CA

MDR report key: 20234697 · Received September 17, 2024

Report

Report Number
3004417597-2024-00047
Event Type
Injury
Date Received
September 17, 2024
Date of Event
June 14, 2024
Manufacturer
B.T.I. BIOTECHNOLOGY INSTITUTE S.L.
Product Code
DZE
PMA / PMN Number
K211952
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, IT IS FOUND THAT THE DRILLING PROTOCOL USED IS DIFFERENT FROM THE RECOMMENDED ONE.

Description of Event or Problem · 0

THE CLINICIAN INDICATES THAT SHE PLACED THE IMPLANT ON (B)(6) 2024 AND FOUR MONTHS LATER IT WAS NOTED THAT THE IMPLANT HAD NOT OSSEOINTEGRATED. PATIENT WITH A BONE QUALITY III. IN THE EVENT THE PATIENT EXPERIENCED: INFECTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2505766 INTERNA NARROW PLATFORM IMPLANT CA DZE B.T.I. BIOTECHNOLOGY INSTITUTE S.L. IIPECA3585 BC00251.B

Patients

Seq Age Sex Outcome Treatment
1 80 YR Female Required Intervention