BEUDAMED
    FDA Adverse Event Injury Summary report: N

    KLOCKNER DENTAL IMPLANTS

    MDR report key: 540710 · Received August 19, 2004

    Report

    Report Number
    9617542-2004-00002
    Event Type
    Injury
    Date Received
    August 19, 2004
    Date of Event
    April 19, 2004
    Report Date
    August 13, 2004
    Manufacturer
    SOADCO, S.L.
    Product Code
    DZE
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SP
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    IMPLANT PLACED BETWEEN "MENTONIANS." REMOVAL OF THE IMPLANT DUE TO A SPRAIN CAUSED BY THE POOR PLACING OF THE MOVABLE PROSTHESIS BY THE PT. THE DENTURE WAS PLACED FIXED IN A SINGLE BALL JOINT, THIS WAS NOT NOTICED AND CAUSED THE LESION WHICH LED TO THE REPLACEMENT OF THE IMPLANT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KLOCKNER DENTAL IMPLANTS DENTAL IMPLANT DZE SOADCO, S.L. 543710 *

    Patients

    Seq Age Sex Outcome Treatment
    1 78 YR Other