FDA Adverse Event Injury Summary report: N

Z-LOOK3

MDR report key: 2850006 · Received November 29, 2012

Report

Report Number
3006948427-2012-00470
Event Type
Injury
Date Received
November 29, 2012
Date of Event
November 3, 2012
Report Date
November 29, 2012
Manufacturer
Z-SYSTEMS AG
Product Code
DZE
PMA / PMN Number
K062542
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
DENTIST

Narratives

Description of Event or Problem · 1

DENTAL IMPLANT DID NOT OSSEOINTEGRATE AND HAD TO BE REMOVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 Z-LOOK3 ENDOSSEOUS DENTAL IMPLANT ROOT FORM DZE Z-SYSTEMS AG Z3 EVO-50-10 14068

Patients

Seq Age Sex Outcome Treatment
1 54 YR Other