GRENGLOO 740-0320

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2010-07-23 for GRENGLOO 740-0320 manufactured by Ormco Corporation.

Event Text Entries

[15558170] On (b)(6), 2010, a doctor reported that two patients experienced enamel removal when the doctor debonded a damon 3mx bracket that had been placed using grengloo with ortho solo. This is the second of two incidents.
Patient Sequence No: 1, Text Type: D, B5


[15846818] The doctor stated that he placed a crown on the tooth and the patient is doing fine. The grengloo kit was not returned for testing, and no lot number was provided, therefore a review of the manufacturing records could not be conducted. A damon 3mx bracket was returned to ormco for evaluation and observed under 30x magnification. It was noted that none of the adhesive came off of the bracket pad. In addition, during a conference call with the doctor on june 25, 2010, the doctor stated that he was bonding the brackets toward the gingiva which is the weaker part of the tooth's enamel and is more susceptible to damage. The doctor also stated that he debonded the brackets without first loosening the adhesive. Going forward, the doctor stated that he will bond the brackets more occlusally and he will start the debonding process by grinding away part of the pad first. The doctor's statements have led to the conclusion that the enamel damage was caused by user error (i. E. Bracket placement and method of debonding) and not by the product itself.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2016150-2010-00102
MDR Report Key1769320
Report Source05
Date Received2010-07-23
Date of Report2010-06-23
Date Mfgr Received2010-06-23
Date Added to Maude2010-07-23
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMR. ORLANDO TADEO, JR.
Manufacturer Street1717 W COLLINS AVE
Manufacturer CityORANGE 92867
Manufacturer CountryUS
Manufacturer Postal92867
Manufacturer Phone7145167419
Manufacturer G1ORMCO CORPORATION
Manufacturer Street1332 SOUTH LONE HILL AVENUE
Manufacturer CityGLENDORA 91740
Manufacturer CountryUS
Manufacturer Postal Code91740
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameGRENGLOO
Generic NameBRACKET ADHESIVE
Product CodeDYH
Date Received2010-07-23
Catalog Number740-0320
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerORMCO CORPORATION
Manufacturer Address1332 SOUTH LONE HILL AVENUE GLENDORA 91740 US 91740


Patients

Patient NumberTreatmentOutcomeDate
101. Other; 2. Required No Informationntervention 2010-07-23

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