PROFILE ORIFICE OPENER FILES OS0319

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 2005-09-09 for PROFILE ORIFICE OPENER FILES OS0319 manufactured by Dentsply Tulsa.

Event Text Entries

[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


MAUDE Entry Details

Report Number2320721-2005-00359
MDR Report Key658422
Report Source05
Date Received2005-09-09
Date of Report2005-08-12
Date of Event2005-08-12
Date Mfgr Received2005-08-12
Date Added to Maude2006-01-04
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationDENTIST
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Manufacturer ContactDR PATRICIA KIHN
Manufacturer StreetSUSQUEHANNA COMMERCE CENTER W 221 W PHILA ST STE 60
Manufacturer CityYORK PA 17404
Manufacturer CountryUS
Manufacturer Postal17404
Manufacturer Phone7178457511
Manufacturer G1DENTSPLY TULSA
Manufacturer Street608 ROLLING HILLS DRIVE
Manufacturer CityJOHNSON CITY TN 37604
Manufacturer CountryUS
Manufacturer Postal Code37604
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePROFILE ORIFICE OPENER FILES
Generic NameDENTAL HAND INSTRUMENT
Product CodeEMR
Date Received2005-09-09
Model NumberNA
Catalog NumberOS0319
Lot NumberUNK
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key647889
ManufacturerDENTSPLY TULSA
Manufacturer Address* JOHNSON CITY TN * US
Baseline Brand NamePROFILE ORIFICE OPENER FILES
Baseline Generic NameDENTAL HAND INSTRUMENT
Baseline Catalog NoOS0319
Baseline Device FamilyPROFILE ORIFICE OPENER FILES
Baseline Shelf Life ContainedN
Baseline Shelf Life [Months]18
Baseline PMA FlagN
Baseline 510K PMNN
Baseline PreamendmentN
Baseline TransitionalN
510k ExemptY


Patients

Patient NumberTreatmentOutcomeDate
10 2005-09-09

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