BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ABUTMENT: SHOULDERED 2MM INTEGRAL 3.25

    MDR report key: 43623 · Received October 22, 1996

    Report

    Report Number
    2023141-1996-00174
    Event Type
    Injury
    Date Received
    October 22, 1996
    Date of Event
    September 18, 1996
    Report Date
    September 25, 1996
    Manufacturer
    CALCITEK
    Product Code
    DZE
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    AN ABUTMENT BROKE IN FUNCTION. PT IS REPORTEDLY FINE. PT IS SAME PT AS MEDWATCH REPORT #2023141-1996-000173.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ABUTMENT: SHOULDERED 2MM INTEGRAL 3.25 Implant SCREW RETAINED DENTAL ABUTMENT DZE CALCITEK NA 961339

    Patients

    Seq Age Sex Outcome Treatment
    1 46 YR Required Intervention