MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,other report with the FDA on 2019-12-20 for PROPEX PIXI APEX LOCATOR A103000000100 manufactured by Dentsply Maillefer.
[178623045]
While there is no indication that serious injury resulted in this event, there has been a previous report received where this malfunction resulted in a serious injury. Therefore, it must be presumed that recurrence of this malfunction could possibly cause or contribute to a serious injury or require medical or surgical intervention to preclude such. As such, this event is reportable per 21cfr part 803. Please note that while this product is not sold in the us, it is considered similar to products that are marketed in the us by dentsply sirona. The device is available for evaluation, though has not been returned as of this report. Evaluation results will be submitted as they become available.
Patient Sequence No: 1, Text Type: N, H10
[178623046]
In this event it was reported that a propex pixi apex locator was giving incorrect measurements. The event outcome is unknown as of this mdr evaluation.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 8031010-2019-00272 |
| MDR Report Key | 9505814 |
| Report Source | FOREIGN,OTHER |
| Date Received | 2019-12-20 |
| Date of Report | 2020-03-02 |
| Date Added to Maude | 2019-12-20 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MR. KARL NITTINGER |
| Manufacturer Street | 221 W. PHILADELPHIA ST. SUITE 60W |
| Manufacturer City | YORK PA 17401 |
| Manufacturer Country | US |
| Manufacturer Postal | 17401 |
| Manufacturer Phone | 7178494424 |
| Manufacturer G1 | FORUM ENGINEERING TECHNOLOGIES (96) LTD. |
| Manufacturer Street | 1 PLATIN STR. NEW INDUSTRIAL ZONE |
| Manufacturer City | RISHON LEZION HAMERKAZ, 7565339 |
| Manufacturer Country | IS |
| Manufacturer Postal Code | 7565339 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | PROPEX PIXI APEX LOCATOR |
| Generic Name | LOCATOR, ROOT APEX |
| Product Code | LQY |
| Date Received | 2019-12-20 |
| Model Number | NA |
| Catalog Number | A103000000100 |
| Lot Number | NA |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | DENTSPLY MAILLEFER |
| Manufacturer Address | CHEMIN DU VERGER 3 BALLAIGUES, 1338 SZ 1338 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-12-20 |