BEUDAMED
    FDA Adverse Event Other Summary report: N

    M.I.T.

    MDR report key: 44695 · Received September 16, 1996

    Report

    Report Number
    1045056-1996-09010
    Event Type
    Other
    Date Received
    September 16, 1996
    Date of Event
    August 23, 1996
    Report Date
    September 3, 1996
    Manufacturer
    MINIMATIC IMPLANT TECHNOLOGY INC.
    Product Code
    DZE
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    IMPLANT FAILED AFTER 6 WKS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 M.I.T. Implant HEX SCREW IMPLANT DZE MINIMATIC IMPLANT TECHNOLOGY INC. IHSSHA508 9502090759

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other