3M ESPE LAVA CHAIRSIDE ORAL SCANNER C.O.S. 68901

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2011-07-20 for 3M ESPE LAVA CHAIRSIDE ORAL SCANNER C.O.S. 68901 manufactured by 3m Espe Dental Products.

Event Text Entries

[2203560] The 3m espe was notified on (b)(6) 2011 that an assistant received a mild electrical shock when scanned with a 3m espe lava chairside oral scanner (c. O. S). The assistant reported pain in the teeth for 2-3 days following the shock. The assistant did not seek add'l medical attention and no serious injury occurred.
Patient Sequence No: 1, Text Type: D, B5


[9401242] The dental office reported that three events occurred within a 2-day period using the same lava c. O. S device. Therefore, three reports are being submitted and this report is related to mfr report# 3005174370-2011-00002 and 3005174370-2011-00003. After equipment installation and during 3ms official certification training of the dentist, the dentist used the lava c. O. S to perform a scan of an assistant. During the scanning procedure, the dentist stated that he felt a palpable current when holding the tip of the wand on his palm. A mild shock occurred to the assistant when the dentist touched the assistant's teeth with his finger; but the dentist did not feel the shock himself. Serial number (b)(4) refers to the unique serial number of the scanning wand component of the lava c. O. S device with a mfr date of 04/2010. Method: an electrical safety check in the dental office revealed that there was a electrical potential between the neutral line and the protective earth on every power outlet the lava c. O. S device was connected to (ranging from 0. 9v to 18v) and the voltage was stable. Also, an initial check of the electrical safety of the device was checked in the office-the lava c. O. S device met its electrical safety specification. Subsequently, the lava c. O. S device was returned to 3m espe and was visually inspected and electrically tested. Other remarks: visual inspection of the wand showed a small gap between the plastic housing and the metal tip of the wand. However, electrical testing confirmed the device met all electrical specifications. The 3m espe reviewed the existing user manual; it instructs the user to examine the wand and the system (cart, screen, etc. ) for physical damage before each use and to contact customer support if there is visible damage. However, electrical testing confirmed the device met all electrical specifications. Conclusions: at this time 3m espe concludes that the lava c. O. S device itself did not cause the electrical shocks but acted as a conductor from a defective socket. The 3m espe continued to investigate this event and will provide supplemental reports, as appropriate.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3005174370-2011-00004
MDR Report Key2214097
Report Source05,06
Date Received2011-07-20
Date of Report2011-06-21
Date of Event2011-06-18
Date Mfgr Received2011-06-21
Device Manufacturer Date2011-01-01
Date Added to Maude2012-06-12
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationDENTIST
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactANGIE DRAPER
Manufacturer Street3M CENTER BLDG 275-2W-08
Manufacturer CitySAINT PAUL MN 551441000
Manufacturer CountryUS
Manufacturer Postal551441000
Manufacturer Phone6517331179
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name3M ESPE LAVA CHAIRSIDE ORAL SCANNER C.O.S.
Generic NameORAL SCANNER
Product CodeNOF
Date Received2011-07-20
Returned To Mfg2011-07-01
Catalog Number68901
ID NumberA10N1007
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
Manufacturer3M ESPE DENTAL PRODUCTS
Manufacturer AddressSAINT PAUL MN US


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2011-07-20

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