PROULTRA ENDO TIP #5 PUENDO5

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 2020-02-07 for PROULTRA ENDO TIP #5 PUENDO5 manufactured by Tulsa Dental Products Llc.

MAUDE Entry Details

Report Number2320721-2020-00005
MDR Report Key9682104
Report SourceHEALTH PROFESSIONAL
Date Received2020-02-07
Date of Report2020-02-07
Date Mfgr Received2020-01-09
Date Added to Maude2020-02-07
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 G1TULSA DENTAL PRODUCTS LLC
Manufacturer Street608 ROLLING HILLS DRIVE
Manufacturer CityJOHNSON CITY TN 37604
Manufacturer CountryUS
Manufacturer Postal Code37604
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePROULTRA ENDO TIP #5
Generic NameSCALER, ULTRASONIC
Product CodeELC
Date Received2020-02-07
Model NumberNA
Catalog NumberPUENDO5
Lot Number0000240341
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerTULSA DENTAL PRODUCTS LLC
Manufacturer Address608 ROLLING HILLS DRIVE JOHNSON CITY TN 37604 US 37604


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-07

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