FDA Adverse Event Injury Summary report: N

AXIOM PX IMPLANT

MDR report key: 8825150 · Received July 25, 2019

Report

Report Number
8020776-2019-00696
Event Type
Injury
Date Received
July 25, 2019
Date of Event
March 23, 2019
Report Date
July 24, 2019
Manufacturer
ANTHOGYR
Product Code
DZE
UDI-DI
03663394002585
PMA / PMN Number
K161177
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
DENTIST

Narratives

Additional Manufacturer Narrative · 1

ACCORDING TO THE PRACTITIONER THE IMPLANT IS LOST (LOSS OF OSTEOINTEGRATION) AFTER IMPLANT HAS BEEN RESTORED. THE IMPLANT HAS BEEN PLACED IN 37 POSITION ON (B)(6) 2018 AND REMOVED ON (B)(6) 2019. 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

IMPLANT IS LOST (LOSS OF OSTEOINTEGRATION) AFTER IMPLANT HAS BEEN RESTORED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
619221 AXIOM PX IMPLANT IMPLANT AXIOM D. 4.0 X 10.0 DZE ANTHOGYR PX40100 18-283762 03663394002585

Patients

Seq Age Sex Outcome Treatment
1 39 YR