MAUDE Adverse Event Report: Nobel Biocare AB Brånemark System Mk III TiU WP 5.0x8.5mm; Endosseous Dental Implant

Catalog Number	28926
Medical Device Problem Code	Migration (4003)
Health Effect - Clinical Code	Unspecified Infection (1930)
Date of Event	01/25/2022
Type of Reportable Event	Serious Injury
Event or Problem Description
Device moved from intended location.

• Brand Name: Brånemark System Mk III TiU WP 5.0x8.5mm
• Common Device Name: Endosseous Dental Implant
• Manufacturer (Section D): Nobel Biocare AB; dimbovägen 2; karlskoga 69151 ; SW 69151
• MDR Report Key: 50110781
• Report Number: 2027971-2026-112369
• Device Sequence Number: 21519403
• Product Code: DZE
• UDI-Device Identifier: 07332747159592
• UDI-Public: (01)07332747159592(10)12030224(17)191002
• Combination Product (Y/N): N
• Initial Reporter Country: FR
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2015
• Device Explanted Year: 2022
• Serviced by Third Party (Y/N): N
• Reporter Type: Importer
• Initial Reporter Occupation: Dentist
• Type of Report: Initial
• Report Date (Section B): 08/01/2026
• Report Date (Section F): 08/01/2026

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 Expiration Date: 10/02/2019
• Device Catalogue Number: 28926
• Device Lot Number: 12030224
• Was Device Available for Evaluation?: Yes
• Date Returned to Manufacturer: 07/28/2026
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: No
• Distributor Facility Aware Date: 07/24/2026
• Event Location: Outpatient Treatment Facility
• Initial Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 08/03/2026
• 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: 62 YR
• Patient Sex: Female