3M UNITEK APC II GEMINI SL SELF-LIGATING BRACKET 3027-382

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2017-12-11 for 3M UNITEK APC II GEMINI SL SELF-LIGATING BRACKET 3027-382 manufactured by 3m Unitek Corporaion.

Event Text Entries

[94474097] The 3m unitek instructions for use state to instruct the patients not to chew or bite on hard substances such as hard candy, ice, carrots, etc. Careful and thorough patient instruction is key to avoiding appliance or enamel damage.
Patient Sequence No: 1, Text Type: N, H10


[94474098] On (b)(6) 2017, 3m was notified by an orthodontist that a patient brought a 3m unitek apc ii gemini sl bracket (ll5) to the office which debonded from tooth #20 with a piece of tooth enamel attached. This bracket was the second bracket that had been bonded to the same tooth; the previous bracket had been bonded on (b)(6) 2017, and the current bracket was bonded (b)(6) 2017. A non-3m brand primer was used during the bonding procedure. Upon follow-up by 3m, it was learned that the enamel damage was down to dentin. The patient admitted to eating halloween candy when the bracket came off. The orthodontist applied composite to fill in the affected area of enamel and re-bonded a non-3m brand bracket. The orthodontist plans to send the patient to their dentist for a permanent restoration at the end of orthodontic treatment.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2020467-2017-00005
MDR Report Key7106464
Report SourceHEALTH PROFESSIONAL
Date Received2017-12-11
Date of Report2017-12-11
Date of Event2017-11-13
Date Mfgr Received2017-11-13
Date Added to Maude2017-12-11
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactANGIE DRAPER
Manufacturer Street2510 CONWAY AVENUE
Manufacturer CityST. PAUL MN 551441000
Manufacturer CountryUS
Manufacturer Postal551441000
Manufacturer Phone6517331179
Manufacturer G13M UNITEK
Manufacturer Street2724 SOUTH PECK RD.
Manufacturer CityMONROVIA CA 910165097
Manufacturer CountryUS
Manufacturer Postal Code910165097
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name3M UNITEK APC II GEMINI SL SELF-LIGATING BRACKET
Generic NameADHESIVE, BRACKET AND TOOTH CONDITIONER, RESIN
Product CodeDYH
Date Received2017-12-11
Catalog Number3027-382
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
Manufacturer3M UNITEK CORPORAION
Manufacturer Address2724 SOUTH PECK RD. MONROVIA CA 910165097 US 910165097


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-12-11

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