MIDWEST PUSH BUTTON LATCH TYPE HEAD 720485

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 2020-01-28 for MIDWEST PUSH BUTTON LATCH TYPE HEAD 720485 manufactured by Sirona Dental Systems Gmbh.

MAUDE Entry Details

Report Number9614977-2019-00158
MDR Report Key9637610
Report SourceHEALTH PROFESSIONAL
Date Received2020-01-28
Date of Report2020-01-28
Date Mfgr Received2019-11-05
Date Added to Maude2020-01-28
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 G1SIRONA DENTAL SYSTEMS GMBH
Manufacturer StreetFABRIKSTRASSE 31
Manufacturer CityBENSHEIM, D-64625
Manufacturer CountryGM
Manufacturer Postal CodeD-64625
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMIDWEST PUSH BUTTON LATCH TYPE HEAD
Generic NameHANDPIECE, CONTRA- AND RIGHT-ANGLE ATTACHMENT, DENTAL
Product CodeEGS
Date Received2020-01-28
Returned To Mfg2019-11-14
Model NumberNA
Catalog Number720485
Lot NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerSIRONA DENTAL SYSTEMS GMBH
Manufacturer AddressFABRIKSTRASSE 31 BENSHEIM, D-64625 GM D-64625


Patients

Patient NumberTreatmentOutcomeDate
10 2020-01-28

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