VDW SILVER RECIPROCATING MOTOR V041163000000

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 2020-03-11 for VDW SILVER RECIPROCATING MOTOR V041163000000 manufactured by Dentsply Vdw Gmbh.

MAUDE Entry Details

Report Number9611053-2020-00056
MDR Report Key9820827
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2020-03-11
Date of Report2020-03-07
Date Added to Maude2020-03-11
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 G1ADVANCED TECHNOLOGY RESEARCH (A.T.R.) S.R.L.
Manufacturer StreetVIA SAN DONATO 1
Manufacturer CityPISTOIA, 51100
Manufacturer CountryIT
Manufacturer Postal Code51100
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVDW SILVER RECIPROCATING MOTOR
Generic NameCONTROLLER, FOOT, HANDPIECE AND CORD
Product CodeEBW
Date Received2020-03-11
Returned To Mfg2020-02-27
Model NumberNA
Catalog NumberV041163000000
Lot NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerDENTSPLY VDW GMBH
Manufacturer AddressBAYERWALDSTRASSE 15 MUNICH, 81737 GM 81737


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-11

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