MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2005-09-09 for PROFILE ORIFICE OPENER FILES OS0319 manufactured by Dentsply Tulsa.
[407298]
It was reported that a file separated in the canal during a procedure. The patient is scheduled for follow-up treatment, though outcome of this event is not known as of this report.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 2320721-2005-00359 |
MDR Report Key | 658422 |
Report Source | 05 |
Date Received | 2005-09-09 |
Date of Report | 2005-08-12 |
Date of Event | 2005-08-12 |
Date Mfgr Received | 2005-08-12 |
Date Added to Maude | 2006-01-04 |
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 | 3 |
Reporter Occupation | DENTIST |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 0 |
Manufacturer Contact | DR PATRICIA KIHN |
Manufacturer Street | SUSQUEHANNA COMMERCE CENTER W 221 W PHILA ST STE 60 |
Manufacturer City | YORK PA 17404 |
Manufacturer Country | US |
Manufacturer Postal | 17404 |
Manufacturer Phone | 7178457511 |
Manufacturer G1 | DENTSPLY TULSA |
Manufacturer Street | 608 ROLLING HILLS DRIVE |
Manufacturer City | JOHNSON CITY TN 37604 |
Manufacturer Country | US |
Manufacturer Postal Code | 37604 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | PROFILE ORIFICE OPENER FILES |
Generic Name | DENTAL HAND INSTRUMENT |
Product Code | EMR |
Date Received | 2005-09-09 |
Model Number | NA |
Catalog Number | OS0319 |
Lot Number | UNK |
ID Number | NA |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Eval'ed by Mfgr | R |
Implant Flag | N |
Date Removed | * |
Device Sequence No | 1 |
Device Event Key | 647889 |
Manufacturer | DENTSPLY TULSA |
Manufacturer Address | * JOHNSON CITY TN * US |
Baseline Brand Name | PROFILE ORIFICE OPENER FILES |
Baseline Generic Name | DENTAL HAND INSTRUMENT |
Baseline Catalog No | OS0319 |
Baseline Device Family | PROFILE ORIFICE OPENER FILES |
Baseline Shelf Life Contained | N |
Baseline Shelf Life [Months] | 18 |
Baseline PMA Flag | N |
Baseline 510K PMN | N |
Baseline Preamendment | N |
Baseline Transitional | N |
510k Exempt | Y |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2005-09-09 |