MAUDE Adverse Event Report: NORIS MEDICAL LTD PTERYFIT IMPLANT; PTERYFIT DENTAL IMPLANT

Model Number	NMAF4218
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Code	Failure of Implant (1924)
Date of Event	03/23/2026
Type of Reportable Event	Serious Injury
Event or Problem Description
The healthcare professional reports the implant was inserted (b)(6) 2025 in the patient's mouth.The patient reported that he broke his permanent prosthesis while eating.He visited his general dentist to evaluate and fix prosthesis, and it was determined that the implant was broken.The patient was then sent to office for evaluation.On (b)(6) 2026, implant fracture was verified.According to the information, the patient is healthy.Observed during the event: implant fracture.The device was forwarded to the manufacturer.No patient operative or post-operative complications reported.

• Brand Name: PTERYFIT IMPLANT
• Common Device Name: PTERYFIT DENTAL IMPLANT
• Manufacturer (Section D): NORIS MEDICAL LTD; hataasia 8; nesher, 36888 08; IS 3688808
• MDR Report Key: 24923196
• Report Number: 3012141159-2026-00117
• Device Sequence Number: 9299097
• Product Code: DZE
• UDI-Device Identifier: 07290108817102
• UDI-Public: 07290108817102
• Combination Product (Y/N): N
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2025
• 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): 04/20/2026
• Report Date (Section F): 04/20/2026

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 Model Number: NMAF4218
• Device Catalogue Number: NMAF4218
• Device Lot Number: 9001391
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: Yes
• Distributor Facility Aware Date: 04/01/2026
• Device Age: 18 MO
• Event Location: Outpatient Treatment Facility
• Date Report to Manufacturer: 04/20/2026
• Initial Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 04/20/2026
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1
• Patient Age: 80 YR
• Patient Sex: Male
• Patient Weight: 96 KG
• Date Report Sent to FDA: 04/20/2026