FDA Adverse Event Injury Summary report: N

ZYGOMATIC IMPLANT

MDR report key: 21917618 · Received April 28, 2025

Report

Report Number
3011390931-2025-00290
Event Type
Injury
Date Received
April 28, 2025
Date of Event
March 25, 2025
Report Date
April 28, 2025
Manufacturer
NORIS MEDICAL LTD
Product Code
DZE
UDI-DI
07290108812336
PMA / PMN Number
K151909
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE DHR WAS REVIEWED FOR LOT#0030626 AND THERE WAS NO EVIDENCE DISCOVERED TO INDICATE THAT A PRODUCT DEFECT OR NON-CONFORMITY CONTRIBUTED TO THE ISSUE. TO DATE, ITEMS OF THE SAME LOT HAVE BEEN SOLD WITHOUT ANY SIMILAR REPORTED EVENT DURING THE PERIOD OF REVIEW. THE INVESTIGATION FOR THIS EVENT HAS NOT IDENTIFIED ANY SIGNALS INDICATING POTENTIAL NON-CONFORMANCES AFFECTING THE MANUFACTURING AND STERILIZATION PROCESSES. OUR MANUFACTURING SYSTEM ASSURES, THAT PRODUCTION AND PROCESS CONTROLS ARE IN PLACE TO ENSURE THAT BATCHES CONFORM TO THE APPLICABLE SPECIFICATIONS BEFORE THEY ARE DISTRIBUTED. SHOULD ADDITIONAL INFORMATION BE RECEIVED WHICH INDICATES THAT THE DEVICE MAY HAVE CAUSED OR CONTRIBUTED TO THE EVENT, AN ADDITIONAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

A HEALTHCARE PROFESSIONAL REPORTED THAT NM-F4440 LOT#0030626 IMPLANT LACKED PRIMARY STABILITY ON TOOTH #10. THE IMPLANT WAS REMOVED DURING IMPLANT PLACEMENT WITH NO REPORT OF OBSERVABLE CLINICAL SYMPTOMS. THE DEVICE WAS FORWARDED TO THE MANUFACTURER. NO OTHER MEDICAL ISSUES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1674995 ZYGOMATIC IMPLANT ZYGOMATIC DENTAL IMPLANT DZE NORIS MEDICAL LTD NM-F4440 0030626 07290108812336

Patients

Seq Age Sex Outcome Treatment
1 72 YR Female