EDDY IRRIGATION TIP V041441000000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2019-10-28 for EDDY IRRIGATION TIP V041441000000 manufactured by Dentsply Vdw Gmbh.

MAUDE Entry Details

Report Number9611053-2019-00368
MDR Report Key9246965
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2019-10-28
Date of Report2019-10-25
Date Mfgr Received2019-09-26
Date Added to Maude2019-10-28
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. KARL NITTINGER
Manufacturer Street221 W. PHILADELPHIA ST. SUITE 60W
Manufacturer CityYORK PA 17401
Manufacturer CountryUS
Manufacturer Postal17401
Manufacturer Phone7178494424
Manufacturer G1DENTSPLY VDW GMBH
Manufacturer StreetBAYERWALDSTRASSE 15
Manufacturer CityMUNICH, 81737
Manufacturer CountryGM
Manufacturer Postal Code81737
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameEDDY IRRIGATION TIP
Generic NameSYRINGE, PERIODONTIC, ENDODONTIC, IRRIGATING
Product CodeEIC
Date Received2019-10-28
Model NumberNA
Catalog NumberV041441000000
Lot NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDENTSPLY VDW GMBH
Manufacturer AddressBAYERWALDSTRASSE 15 MUNICH, 81737 GM 81737


Patients

Patient NumberTreatmentOutcomeDate
10 2019-10-28

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