FDA Adverse Event Malfunction Summary report: N

BYTE DAY ALIGNERS

MDR report key: 20643341 · Received November 8, 2024

Report

Report Number
3014845255-2024-02536
Event Type
Malfunction
Date Received
November 8, 2024
Report Date
October 29, 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 AFTER ONE MONTH OF USING THE ALIGNERS UNDER EXCRUCIATING PAIN AND DENTIST ADVISED TO STOP USING THE ALIGNER. THE DENTIST'S EVALUATION ALSO NOTED LIMITED JAW OPENING. CURRENT UPPER/LOWER ALIGNERS #2. DENTAL HISTORY INCLUDES ORTHODONTIC BRACES, RETAINER, AND EXPANDER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2110741 BYTE DAY ALIGNERS ALIGNER, SEQUENTIAL NXC STRAIGHT SMILE, LLC HBYTE TRAY 00850017524163

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown