PALODENT PLUS FORCEPS 659810

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 2020-02-27 for PALODENT PLUS FORCEPS 659810 manufactured by Dentsply Caulk.

MAUDE Entry Details

Report Number2515379-2020-00001
MDR Report Key9760598
Report SourceHEALTH PROFESSIONAL
Date Received2020-02-27
Date of Report2020-02-26
Date Mfgr Received2020-01-27
Date Added to Maude2020-02-27
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
Manufacturer CountryUS
Manufacturer Phone8494424
Manufacturer G1DENTSPLY CAULK
Manufacturer Street38 W. CLARK AVE.
Manufacturer CityMILFORD, DE
Manufacturer CountryUS
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePALODENT PLUS FORCEPS
Generic NameINSTRUMENTS, DENTAL HAND
Product CodeDZN
Date Received2020-02-27
Model NumberNA
Catalog Number659810
Lot NumberA81018
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerDENTSPLY CAULK
Manufacturer Address38 W. CLARK AVE. MILFORD, DE US


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-27

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