SURGIGUIDE 37502

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-09-16 for SURGIGUIDE 37502 manufactured by Dentsply Implants N.v..

Event Text Entries

[55002893] Since this event resulted in medical/surgical intervention to preclude permanent damage to a body structure or permanent impairment of a body function, it must be presumed that the malfunction would be likely to cause or contribute to a serious injury should it recur. As such, this event meets the definition of a reportable event per 21 cfr part 803. The device is available for evaluation, though results are not available as of this report. Evaluation results will be submitted as they become available.
Patient Sequence No: 1, Text Type: N, H10


[55002894] It was reported that a surgiguide was used to create the osteotomy for two dental implants (tooth position 7 and 10). After the first drilling step the surgical guide was removed to complete the additional drilling steps free handed according to the pilot guide drilling protocol. After placing the implants free handed, the customer discovered that the implant in #7 was positioned correctly but the implant in #10 was positioned too distal. A second surgery is needed to correct the positioning of implant in #10.
Patient Sequence No: 1, Text Type: D, B5


[58618540] We have reviewed the matching of the plaster model onto the ct images carefully and we could confirm that the matching is optimal. We received notes indicating that the doctor had positioned the implant on position 10 in the middle of the edentulous space. We however noticed that this was not managed properly. As the implant position goes more distal as expected, it might be that there was a perception issue during the planning. Suggested to consider the use of a fully-guided implant safe guide to have a full sequenced drill and implant guidance.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3007362683-2016-00010
MDR Report Key5958449
Date Received2016-09-16
Date of Report2016-08-19
Date Mfgr Received2016-09-27
Date Added to Maude2016-09-16
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationDENTIST
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMRS. HELEN LEWIS
Manufacturer Street221 W. PHILADELPHIA ST. SUITE 60W
Manufacturer CityYORK PA 17401
Manufacturer CountryUS
Manufacturer Postal17401
Manufacturer Phone7178494229
Manufacturer G1DENTSPLY IMPLANTS N.V.
Manufacturer StreetRESEARCH CAMPUS 10
Manufacturer CityHASSELT LIMBURG, B-3500
Manufacturer CountryBE
Manufacturer Postal CodeB-3500
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Sequence Number: 1

Brand NameSURGIGUIDE
Generic NameSYSTEM, IMAGE PROCESSING, RADIOLOGICAL
Product CodeLLZ
Date Received2016-09-16
Returned To Mfg2016-08-19
Model NumberNA
Catalog Number37502
Lot NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerDENTSPLY IMPLANTS N.V.
Manufacturer AddressRESEARCH CAMPUS 10 HASSELT LIMBURG, B-3500 BE B-3500

Device Sequence Number: 2

Product CodeDZE
Date Received2016-09-16
Device Eval'ed by MfgrY
Device Sequence No2
Device Event Key0

Device Sequence Number: 3

Product CodeEBG
Date Received2016-09-16
Device Eval'ed by MfgrY
Device Sequence No3
Device Event Key0


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2016-09-16

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