FDA Adverse Event Malfunction Summary report: N

BYTE DAY ALIGNERS

MDR report key: 20608975 · Received November 5, 2024

Report

Report Number
3014845255-2024-02429
Event Type
Malfunction
Date Received
November 5, 2024
Report Date
October 10, 2025
Manufacturer
STRAIGHT SMILE, LLC
Product Code
NXC
UDI-DI
00850017524163
PMA / PMN Number
K230199
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THERE HAS BEEN A PREVIOUS REPORT RECEIVED WHERE THIS MALFUNCTION RESULTED IN A SERIOUS INJURY. THEREFORE, IT MUST BE PRESUMED THAT RECURRENCE OF THIS MALFUNCTION COULD POSSIBLY CAUSE OR CONTRIBUTE TO A SERIOUS INJURY OR REQUIRE MEDICAL OR SURGICAL INTERVENTION TO PRECLUDE SUCH. AS SUCH, THIS EVENT IS REPORTABLE PER 21CFR PART 803.

Additional Manufacturer Narrative · 0

A DHR REVIEW WAS CONDUCTED WITH NO DISCREPANCIES NOTED.

Description of Event or Problem · 0

PATIENT REPORTS MISSING A TOOTH #13 ON THE LEFT SIDE AND THE ALIGNERS DON'T GO TO THE GUMS. THIS IS CAUSING THE CHEEK TO GET SUCTIONED INTO THE OPEN SPACE AND BE CUT BY THE ALIGNERS, CREATING AN ULCER. DENTAL HISTORY INCLUDES CROWNS IN LOCATION #5 AND PRIOR ROOT CANAL TREATMENT. NOTE: THE BYTE CLINICAL SUPPORT TEAM (CST) PROVIDED HHT (HEREDITARY HEMORRHAGIC TELANGIECTASIA) & T AND FILING TO HELP AND LET US KNOW IF HELPED. GATHERING VIDEO OF STEP 1 AND COMPARING SHAPE FROM STEP 1 AND 2 TO SEE IF ANY BETTER. MEDICAL HISTORY INCLUDED WELLBUTRIN AND FOCALIN PRESCRIPTIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
72238 BYTE DAY ALIGNERS ALIGNER, SEQUENTIAL NXC STRAIGHT SMILE, LLC HBYTE TRAY 00850017524163

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown