LUXSTAR STANDARD POST-MOUNT LIGHT UL1000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-02-08 for LUXSTAR STANDARD POST-MOUNT LIGHT UL1000 manufactured by Marus.

Event Text Entries

[67243485] The lens heat shield/holder from the dental light has a three prong locking mechanism which locks the lens heat shield/cover into place. The lens heat shield/cover has to be removed by the end user when cleaning the lens or replacing the halogen bulb during routine operator maintenance. The installation instructions, use and care instructions, and labeling clearly state to ensure the lens heat shield/holder is properly secure by snapping the part back into place. Marus initiated a recall on june 10, 2011 to add a tether to the lens heat shield/cover to keep it from falling off the dental light if it is not re-installed properly. The fda closed this recall on 10/26/2012 (please reference fda recall z-2834-2011). Marus notified all distributors of the recall while the recall was open. The doctor and his current service provider could not locate the serial number on this particular light. They both informed marus the light was very old and the serial number tag must have somehow been removed. After following back up with the dentist on 2/8/2017, the dental office informed marus the tether was installed on the dental light and it is working properly.
Patient Sequence No: 1, Text Type: N, H10


[67243486] A dental professional was treating a patient when the lens heat shield cover fell off a marus dental light hitting the patient on the neck causing a small burn. There were no serious injuries reported. No medical attention was required.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1017522-2017-00005
MDR Report Key6312880
Date Received2017-02-08
Date of Report2017-01-13
Date of Event2017-01-13
Date Mfgr Received2017-01-13
Date Added to Maude2017-02-08
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. FRANK RAY
Manufacturer Street11727 FRUEHAUF DRIVE
Manufacturer CityCHARLOTTE NC 28273
Manufacturer CountryUS
Manufacturer Postal28273
Manufacturer Phone7045877227
Manufacturer G1MARUS
Manufacturer Street11727 FRUEHAUF DRIVE
Manufacturer CityCHARLOTTE NC 28273
Manufacturer CountryUS
Manufacturer Postal Code28273
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameLUXSTAR STANDARD POST-MOUNT LIGHT
Generic NameDENTAL LIGHT
Product CodeEAZ
Date Received2017-02-08
Model NumberUL1000
Catalog NumberUL1000
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerMARUS
Manufacturer Address11727 FRUEHAUF DRIVE CHARLOTTE NC 28273 US 28273


Patients

Patient NumberTreatmentOutcomeDate
10 2017-02-08

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