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