| Brand Name | Bridge Screw Hex |
| Common Device Name | accessories, implant, dental, endosseous |
| Manufacturer (Section D) |
| Dentsply Implants Manufacturing GmbH |
| rodenbacher chaussee 4 |
| hanau hessen 63457 |
| GM 63457 |
|
| Manufacturer Contact |
|
|
| mr. dan eagar |
| suite 60w |
| york, PA 17401
|
|
| MDR Report Key | 50823179 |
| Report Number | 3013111692-2026-41502 |
| Device Sequence Number | 15991961 |
| Product Code |
NDP
|
| UDI-Device Identifier | 07392532001765 |
| UDI-Public | 07392532001765 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| PMA/510(K) Number | K053384 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/18/2026 |
| 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? |
Yes
|
| Device Lot Number | 198847 |
| Was Device Available for Evaluation? |
Yes
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/25/2026 |
| Initial Report FDA Received Date | 09/18/2026 |
| 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) |
Yes
|
| Usage of Device |
Unknown
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Sex | Male |
|
|