BEUDAMED
    FDA Adverse Event Other Summary report: N

    O BUTMENT

    MDR report key: 59661 · Received December 26, 1996

    Report

    Report Number
    1627417-1996-90005
    Event Type
    Other
    Date Received
    December 26, 1996
    Date of Event
    June 20, 1996
    Report Date
    December 18, 1996
    Manufacturer
    "O" CO, INC.
    Product Code
    DZE
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    PT HAD A COMBINATION OF FACTORS THAT COULD HAVE LEAD TO IMPLANT FAILURE SUCH AS SMOKING, POOR ORAL HYGIENE & HE WORKED IN A TOXIC ENVIRONMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 O BUTMENT Implant DENTAL IMPLANT DZE "O" CO, INC. TWO IMPLANTS 1774,1770,1773

    Patients

    Seq Age Sex Outcome Treatment
    1 59 YR Other