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