| Brand Name | ADIN DENTAL IMPLANTS |
| Common Device Name | ISPS0842 |
| Manufacturer (Section D) |
| ADIN DENTAL IMPLANTS LTD. |
| industrial zone alon tavor |
| pob 1128 |
| afula, isr, 18111 01 |
| IS 1811101 |
|
| MDR Report Key | 24664745 |
| Report Number | 3013143972-2026-00199 |
| Device Sequence Number | 18452462 |
| Product Code |
DZE
|
| UDI-Device Identifier | 07290105151773 |
| UDI-Public | 7290105151773 |
| Combination Product (Y/N) | N |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2026 |
| Device Explanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Importer
|
| Initial Reporter Occupation |
Dentist
|
| Type of Report
| Initial |
| Report Date (Section B) |
03/19/2026 |
| 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
|
| Device Catalogue Number | ISPS0842 |
| Device Lot Number | 7905279 |
| Was Device Available for Evaluation? |
Yes
|
| Is the Reporter a Health Professional? |
Yes
|
| Distributor Facility Aware Date | 03/11/2026 |
| Event Location |
Outpatient Treatment Facility
|
| Initial Date Received by Manufacturer | Not provided |
| Initial Report FDA Received Date | 03/23/2026 |
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Age | 56 YR |
| Patient Sex | Unknown |
|
|