FDA Adverse Event Injury Summary report: N

ATLANTIS ABUTMENT TI

MDR report key: 22817305 · Received August 15, 2025

Report

Report Number
1222802-2025-00022
Event Type
Injury
Date Received
August 15, 2025
Report Date
August 15, 2025
Manufacturer
DENTSPLY IH INC.
Product Code
NHA
UDI-DI
07392532083433
PMA / PMN Number
MULTIPLE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VT, US
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THEREFORE, BECAUSE A SERIOUS INJURY RESULTED, THIS EVENT IS REPORTABLE PER 21 CFR PART 803. SECTION H6 WAS DONE BASED ON THE INFORMATION PROVIDED BY THE INITIAL REPORTER AND OUR LONG-TIME EXPERIENCE IN THE INVESTIGATION OF SIMILAR COMPLAINTS. PRODUCT RETURN IS REQUESTED AND PRODUCT WILL BE EVALUATED AFTER RECEIPT. IN CASE ANY NEW OR ADDITIONAL INFORMATION WILL BE GAINED FROM THIS INVESTIGATION A FOLLOW-UP REPORT WILL BE SENT. TREND IS TRACKED AND MONITORED.

Description of Event or Problem · 0

IN THIS EVENT IT IS REPORTED THAT AN ATLANTIS ABUTMENT TI ABUTMENT HAS BENT SCREW. THE ABUTMENT IS STILL IN PATIENT'S MOUTH. THE IMPLANT IS NOT LOADABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2726341 ATLANTIS ABUTMENT TI ABUTMENT, IMPLANT, DENTAL, ENDOSSEOUS NHA DENTSPLY IH INC. UNK 07392532083433

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown