FDA Adverse Event
Injury
Summary report: N
SEVEN INTERNAL HEX. IMPLANT DIA. 3.75 L 11.50MM
MDR report key: 24744387
·
Received March 31, 2026
Report
- Report Number
- 3004203816-2026-08808
- Event Type
- Injury
- Date Received
- March 31, 2026
- Report Date
- March 31, 2026
- Manufacturer
- MIS IMPLANTS TECHNOLOGIES LTD.
- Product Code
- DZE
- UDI-DI
- 07290108999020
- PMA / PMN Number
- K180282
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- DENTIST
- Health Professional
- Yes
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
MIS WARRANTY. CUSTOMER REPORTED. IMPLANT LOSS. SF (B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 801094 | SEVEN INTERNAL HEX. IMPLANT DIA. 3.75 L 11.50MM | IMPLANT, ENDOSSEOUS, ROOT-FORM | DZE | MIS IMPLANTS TECHNOLOGIES LTD. | W25007453 | 07290108999020 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Male | Required Intervention | NOT PROVIDED |