SYBRONENDO 973-0322

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-05-24 for SYBRONENDO 973-0322 manufactured by Sybronendo.

Event Text Entries

[109619146] Specific information with regard to the exact number of patients affected, genders, ages, and weights was not provided. The date of event was not provided. Device manufacture date is pending. The doctor reported that when root canals failed extractions had to be done and implants inserted. The product has been identified as an affected product in an ongoing class ii recall; therefore, no further evaluation is necessary.
Patient Sequence No: 1, Text Type: N, H10


[109619147] A doctor alleged that there were cases were postoperative sensitivity and root canal failure had occured when using the elements obturation unit with buchanan tips.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2016150-2018-00019
MDR Report Key7543397
Date Received2018-05-24
Date of Report2018-05-24
Date Mfgr Received2018-05-24
Date Added to Maude2018-05-24
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 Location3
Manufacturer ContactMR. PAULO CALLE
Manufacturer Street1717 W COLLINS AVENUE
Manufacturer CityORANGE CA 92867
Manufacturer CountryUS
Manufacturer Postal92867
Manufacturer Phone7145167752
Manufacturer G1SYBRONENDO
Manufacturer Street1332 SOUTH LONE HILL AVENUE
Manufacturer CityGLENDORA CA 91740
Manufacturer CountryUS
Manufacturer Postal Code91740
Single Use3
Previous Use Code3
Removal Correction NumberZ-0413-2018
Event Type3
Type of Report0

Device Details

Brand NameSYBRONENDO
Generic NameELEMENTS OBTURATION UNIT,
Product CodeEKZ
Date Received2018-05-24
Catalog Number973-0322
OperatorDENTIST
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSYBRONENDO
Manufacturer Address1332 SOUTH LONE HILL AVENUE GLENDORA CA 91740 US 91740


Patients

Patient NumberTreatmentOutcomeDate
10 2018-05-24

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