FDA Adverse Event
Injury
Summary report: N
ASTRATECH IMPL EV 4.2S 11MM OS
MDR report key: 24632686
·
Received March 18, 2026
Report
- Report Number
- 3013111692-2026-08674
- Event Type
- Injury
- Date Received
- March 18, 2026
- Date of Event
- January 16, 2026
- Report Date
- March 18, 2026
- Manufacturer
- DENTSPLY IMPLANTS MANUFACTURING GMBH
- Product Code
- DZE
- UDI-DI
- 07392532214271
- PMA / PMN Number
- K120414
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GM
- 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. 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
CUSTOMER REPORTED AN IMPLANT LOSS - MOBILITY IMPLANT REGION 25 DID NOT HEAL, HAD TO BE REMOVED, IMPRESSION TAKEN BEFOREHAND AT HZA WHERE THE IMPLANT LOOSENED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 689729 | ASTRATECH IMPL EV 4.2S 11MM OS | IMPLANT, ENDOSSEOUS, ROOT-FORM | DZE | DENTSPLY IMPLANTS MANUFACTURING GMBH | 526372 | 07392532214271 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown | Required Intervention | IMPLANT WITH GF. |