FDA Adverse Event Other Summary report: N

MAXIMUS OS IMPLANT

MDR report key: 654631 · Received September 15, 2005

Report

Report Number
1060818-2005-00001
Event Type
Other
Date Received
September 15, 2005
Date of Event
May 5, 2005
Report Date
August 17, 2005
Manufacturer
BIOHORIZONS IMPLANT SYSTEMS, INC.
Product Code
DZE
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
DENTIST

Narratives

Description of Event or Problem · 1

THE CLINICIAN PREPPED A PATIENT FOR ENDOSSEOUS IMPLANTS, INCLUDING DRILLING OSTEOTOMIES, AND WAS NOT AWARE THAT DIFFERENT PLACEMENT INSTRUTMENTS, WHICH THE CUSTOMER HAD NOT RECEIVED, WERE NEEDED FOR THE IMPLANT MODEL BEING PLACED. THE CUSTOMER CLOSED THE SURGICAL SITES, RESCHEDULED THE PATIENT FOR THE PROCEDURE, AND SUBSEQUENTLY PLACED AND RESTORED THE IMPLANTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MAXIMUS OS IMPLANT ENDOSSEOUS DENTAL IMPLANT DZE BIOHORIZONS IMPLANT SYSTEMS, INC. 3512OS4 S1104001

Patients

Seq Age Sex Outcome Treatment
1 NO INFO Other