FDA Adverse Event Injury Summary report: N

SEVEN XD INT. HEX. IMPLANT D4.2 L8MM, SP

MDR report key: 23057268 · Received September 15, 2025

Report

Report Number
3004203816-2025-36824
Event Type
Injury
Date Received
September 15, 2025
Report Date
September 15, 2025
Manufacturer
MIS IMPLANTS TECHNOLOGIES LTD.
Product Code
DEZ
UDI-DI
07290113997691
PMA / PMN Number
K180282
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CS
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

SINCE THIS EVENT RESULTED IN A SERIOUS INJURY, IT IS REPORTABLE PER 21 CFR PART 803. THE DEVICE WAS NOT EVALUATED BECAUSE THE ISSUE IS A KNOWN INHERENT RISK OF THE DEVICE. WE WILL CONTINUE TO TRACK AND MONITOR THE TREND.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT EXPERIENCED A DENTAL IMPLANT LOSS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1759579 SEVEN XD INT. HEX. IMPLANT D4.2 L8MM, SP IGM, RHODAMINE, ANTIGEN, ANTISERUM, CONTROL DEZ MIS IMPLANTS TECHNOLOGIES LTD. W24000350 07290113997691

Patients

Seq Age Sex Outcome Treatment
1 NA Female Required Intervention