MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 1998-09-17 for TRANSCEND 2300-604 manufactured by 3m Unitek.
[20521953]
Orthodontist reported that while debonding transcend ceramic brackets in 1994, a horizontal fracture occurred on the upper right lateral incisor. The tooth became necrotic some time later and subsequently required root canal therapy in 1998.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 2020467-1998-00005 |
MDR Report Key | 187803 |
Report Source | 05 |
Date Received | 1998-09-17 |
Date of Report | 1998-09-10 |
Date of Event | 1994-04-08 |
Date Mfgr Received | 1998-09-10 |
Date Added to Maude | 1998-09-21 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 0 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 0 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | TRANSCEND |
Generic Name | ORTHODONTIC CERAMIC BRACKET |
Product Code | DYW |
Date Received | 1998-09-17 |
Model Number | NA |
Catalog Number | 2300-604 |
Lot Number | UNK |
ID Number | * |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Eval'ed by Mfgr | R |
Implant Flag | N |
Date Removed | A |
Device Sequence No | 1 |
Device Event Key | 182520 |
Manufacturer | 3M UNITEK |
Manufacturer Address | 2724 SOUTH PECK RD. MONROVIA CA 91016 US |
Baseline Brand Name | TRANSCEND |
Baseline Generic Name | CERAMIC BRACKET |
Baseline Model No | * |
Baseline Catalog No | 2300-604 |
Baseline ID | SERIES 6000 |
Baseline Device Family | TRANSCEND |
Baseline Shelf Life Contained | Y |
Baseline Shelf Life [Months] | 36 |
Baseline PMA Flag | N |
Baseline 510K PMN | Y |
Premarket Notification | K861965 |
Baseline Preamendment | N |
Baseline Transitional | N |
510k Exempt | N |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 3 | 1. Required No Informationntervention | 1998-09-17 |