FDA Adverse Event
Injury
Summary report: N
TS III SA
MDR report key: 22073082
·
Received May 22, 2025
Report
- Report Number
- 3003394081-2025-00001
- Event Type
- Injury
- Date Received
- May 22, 2025
- Date of Event
- January 21, 2025
- Report Date
- March 15, 2025
- Manufacturer
- OSSTEM IMPLANT CO., LTD.
- Product Code
- DZE
- PMA / PMN Number
- K222778
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- DENTIST
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
DENTAL IMPLANT FACTURE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1219841 | TS III SA | DENTAL IMPLANT | DZE | OSSTEM IMPLANT CO., LTD. | TS3S4008S | FTN20B804 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown | Required Intervention |