| Brand Name | CAMLOG SCREW-LINE IMPLANT PROMOTE-PLUS |
| Common Device Name | CAMLOG SCREW-LINE IMPLANT PROMOTE-PLUS |
| Manufacturer (Section D) |
| ALTATEC GMBH |
| maybachstrasse.5 |
| wimsheim, |
| GM |
|
| Manufacturer (Section G) |
| ALTATEC GMBH |
| maybachstrasse.5 |
|
| wimsheim, 71299 |
|
GM
71299
|
|
| Manufacturer Contact |
|
monika
hentschel
|
| maybachstrasse 5 |
| wimsheim, 71299
|
|
GM
71299
|
|
| MDR Report Key | 24738497 |
| Report Number | 9613866-2026-50434 |
| Device Sequence Number | 9790722 |
| Product Code |
DZE
|
| Combination Product (Y/N) | N |
| Initial Reporter Country | GM |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2015 |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional |
| Initial Reporter Occupation |
Dentist
|
| Type of Report
| Initial |
| Report Date (Section B) |
03/30/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
Yes
|
| Is this a Product Problem Report? |
No
|
| Operator of Device |
Health Professional
|
| Device Model Number | K1052.3813 |
| Device Lot Number | 0040065381 |
| Was Device Available for Evaluation? |
Yes
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 03/17/2026 |
| Initial Report FDA Received Date | 03/31/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Age | 59 YR |
| Patient Sex | Male |
|
|