FDA Adverse Event Injury Summary report: N

BIOHORIZONS INTERNAL DENTAL IMPLANT

MDR report key: 824963 · Received March 6, 2007

Report

Report Number
1060818-2007-00014
Event Type
Injury
Date Received
March 6, 2007
Date of Event
January 20, 2007
Report Date
March 6, 2007
Manufacturer
BIOHORIZONS IMPLANT SYSTEMS, INC.
Product Code
DZE
PMA / PMN Number
k042429
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TU
Reporter Occupation
DENTIST

Narratives

Additional Manufacturer Narrative · 1

THE IMPLANT WAS NOT FRACTURED. THE IMPLANT WAS EXAMINED UNDER 20X MAGNIFICATION AND NO THREAD DEFECTS WERE NOTED. THE IMPLANT UNIT RETURNED WAS WITHIN SPECIFICATION. ADD'L CAT# PYR3512, LOT# S1006030, EXP DATE: 10/01/2011, DEVICE MFR DATE 10/2006.

Description of Event or Problem · 1

REMOVAL OF DENTAL IMPLANT. THE CLINICIAN REPORTED THE IMPLANTS WERE REMOVED THE SAME DAY BECAUSE OF PT BONE QUALITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BIOHORIZONS INTERNAL DENTAL IMPLANT IMPLANT, ENDOSSEOUS, ROOT-FORM DZE BIOHORIZONS IMPLANT SYSTEMS, INC. NA S0805038

Patients

Seq Age Sex Outcome Treatment
1 60 YR Other