FDA Adverse Event
Injury
Summary report: N
M5B-10375
MDR report key: 25121758
·
Received May 8, 2026
Report
- Report Number
- 3004203816-2026-12190
- Event Type
- Injury
- Date Received
- May 8, 2026
- Report Date
- May 8, 2026
- Manufacturer
- MIS IMPLANTS TECHNOLOGIES LTD.
- Product Code
- DZE
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GR
- 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
IT WAS REPORTED THAT A PATIENT EXPERIENCED A DENTAL IMPLANT LOSS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 580043 | M5B-10375 | IMPLANT, ENDOSSEOUS, ROOT-FORM | DZE | MIS IMPLANTS TECHNOLOGIES LTD. | W25002084 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 62 YR | Male | Required Intervention |