FDA Adverse Event Injury Summary report: N

AXIOM PX IMPLANT

MDR report key: 8123928 · Received December 3, 2018

Report

Report Number
8020776-2018-01433
Event Type
Injury
Date Received
December 3, 2018
Date of Event
August 29, 2018
Report Date
November 26, 2018
Manufacturer
ANTHOGYR
Product Code
DZE
UDI-DI
03663394002523
PMA / PMN Number
K161177
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
DENTIST

Narratives

Additional Manufacturer Narrative · 1

ACCORDING TO THE PRACTITIONER THE IMPLANT DIDN'T TAKE AND FAILED TO INTEGRATE. THE IMPLANT HAS BEEN PLACED IN 24 POSITION ON (B)(6) 2018. 25 DAY LATER AFTER THE IMPLANTATION, THE PRACTITIONER HAS FOUND THAT THE IMPLANT FAILED TO INTEGRATE. THE IMPLANT HAS FOLLOWED THE COMPLETE MANUFACTURING CYCLE, HAS BEEN VERIFIED AT EACH STAGE OF PRODUCTION, AND HAS BEEN SUBMITTED TO A FINAL RELEASE BEFORE PROVISION OF THE DEVICE ON THE MARKET, WHICH ULTIMATELY GUARANTEES ITS CONFORMITY. THE IMPLANT HAS BEEN EVALUATED THROUGH A BIOLOGICAL RISK ASSESSMENT WHICH CONCLUDES THAT ITS TOXICOLOGICAL PROFILE IS ACCEPTABLE. THE IMPLANT LOSS SUGGESTS THAT THE SOURCE OF THE PROBLEM WAS LIKELY TO COME FROM PROCEDURAL ERRORS AND/OR THE LACK OF OSSEOINTEGRATION. ADDITIONALLY, OTHER FACTORS THAT MAY HAVE CONTRIBUTED TO THE IMPLANT FAILURE INCLUDE BONE CONDITION, PATIENT ORAL HYGIENE, OR PATIENT BEHAVIOR.

Description of Event or Problem · 1

THE IMPLANT FAILS TO OSSEOINTEGRATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
965329 AXIOM PX IMPLANT IMPLANT AXIOM D.3.4 X 12.0 DZE ANTHOGYR PX34120 18-238430 03663394002523

Patients

Seq Age Sex Outcome Treatment
1 46 YR