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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALIGN TECHNOLOGY, INC. INVISALIGN SYSTEM; SEQUENTIAL ALIGNERS

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ALIGN TECHNOLOGY, INC. INVISALIGN SYSTEM; SEQUENTIAL ALIGNERS Back to Search Results
Model Number INVISALIGN SYSTEM - MODERATE
Device Problem Appropriate Term/Code Not Available (3191)
Patient Problem Chest Pain (1776)
Event Date 12/01/2021
Event Type  Injury  
Manufacturer Narrative
No conclusive evidence has been provided that supports or opposes the fact that the invisalign system aligners caused or contributed to the reported symptom.This event is being filed as an mdr as the patient reported the symptom of chest pain and there was no conclusive evidence that the invisalign product was not related to the event.
 
Event Description
The patient reported symptoms of chest pain and stomach issues.The patient reported visiting a specialist and was diagnosed with severe gastroparesis.The patient did not report taking or being prescribed medication to alleviate the reported symptoms.The treatment was discontinued on an unspecified date and the patient is currently getting better." the treating doctor shared the potential root cause could have been that the aligners exacerbated the condition.
 
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Brand Name
INVISALIGN SYSTEM
Type of Device
SEQUENTIAL ALIGNERS
Manufacturer (Section D)
ALIGN TECHNOLOGY, INC.
2820 orchard parkway
san jose CA 95134
Manufacturer Contact
ryan hoffmeister
2820 orchard parkway
san jose, CA 95134
4087891588
MDR Report Key13161094
MDR Text Key285565629
Report Number2953749-2021-04152
Device Sequence Number1
Product Code NXC
Combination Product (y/n)N
Reporter Country CodeAS
PMA/PMN Number
K181739
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional
Reporter Occupation Dentist
Type of Report Initial
Report Date 01/04/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/04/2022
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Lay User/Patient
Device Model NumberINVISALIGN SYSTEM - MODERATE
Device Catalogue Number8828
Device Lot Number200561782
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received12/01/2021
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured04/12/2021
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Other;
Patient Age30 YR
Patient SexFemale
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