BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SCRE3W-VENT DENTAL IMPLANT

    MDR report key: 23141 · Received June 27, 1994

    Report

    Report Number
    2028280-1994-00292
    Event Type
    Injury
    Date Received
    June 27, 1994
    Report Date
    June 10, 1994
    Manufacturer
    CORE-VENBIO-ENGINEERING
    Product Code
    DZE
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    MI, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    DENTAL IMPLANT BROKE WHILE IN FUNCTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SCRE3W-VENT DENTAL IMPLANT ENDOSTEAL DENTAL IMPLANT DZE CORE-VENBIO-ENGINEERING SV13 HEX-HOLE NI

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO Required Intervention