MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 1996-11-08 for TRANSCEND UNK manufactured by 3m Unitek Corp..
[21626975]
While debonding a ceramic bracket from tooth #10, the coronal 2/3 of the tooth fractured off. Follow-up therapy included endodontic treatment and a porcelain crown.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 2020467-1996-00012 |
MDR Report Key | 48525 |
Report Source | 05 |
Date Received | 1996-11-08 |
Date of Report | 1996-10-21 |
Date of Event | 1990-05-01 |
Date Added to Maude | 1996-11-14 |
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 |
Reporter Occupation | DENTIST |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
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 | 1996-11-08 |
Model Number | UNK |
Catalog Number | UNK |
Lot Number | UNK |
ID Number | NA |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Age | * |
Device Eval'ed by Mfgr | N |
Implant Flag | N |
Date Removed | * |
Device Sequence No | 1 |
Device Event Key | 49294 |
Manufacturer | 3M UNITEK CORP. |
Manufacturer Address | 2724 SO PECK RD MONROVIA CA 91016 US |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Required No Informationntervention | 1996-11-08 |