FDA Adverse Event Malfunction Summary report: N

ENDSNORZ SLEEP APPLIANCE

MDR report key: 18793800 · Received February 27, 2024

Report

Report Number
3011649314-2024-00141
Event Type
Malfunction
Date Received
February 27, 2024
Date of Event
December 28, 2023
Report Date
October 12, 2025
Manufacturer
PRISMATIK DENTALCRAFT, INC.
Product Code
LRK
PMA / PMN Number
K211069
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

AT THIS TIME, THE EXACT CAUSE OF THE EVENT IS UNKNOWN AND CURRENTLY UNDER INVESTIGATION. THE PROVIDER MENTIONED THAT THE APPLIANCE WAS SENT TO THE MANUFACTURER. ONCE THE DEVICE IS RECEIVED AND EVALUATED A SUPPLEMENTAL REPORT WILL BE PROVIDED AT THE CONCLUSION OF THE INVESTIGATION. THE MANUFACTURER INTERNAL REFERENCE NUMBER IS: (B)(4).

Additional Manufacturer Narrative · 0

THE DEVICE WAS EVALUATED, THE INVESTIGATION HAS BEEN COMPLETED AND THE RESULTS ARE AS FOLLOWS: DHR RESULTS. THE DEVICE WAS MANUFACTURED AT THE NEW WEST LAB. THE CASE ORDER FOR THE CASE NUMBER WAS REVIEWED, AND NO ANOMALIES WERE IDENTIFIED THAT MAY HAVE CONTRIBUTED TO THE REPORTED EVENT. STOCK PRODUCT REVIEWED RESULTS. NO STOCK PRODUCT WAS AVAILABLE FOR REVIEW SINCE THE DEVICE WAS FABRICATED PER PHYSICIAN'S PRESCRIPTION ONLY. INVESTIGATION METHODS/RESULTS. THE REPORTED PRODUCT WAS NOT RETURNED TO THE COMPLAINT HANDLING TEAM. HOWEVER, IT WAS REPORTED THAT A DEVICE WAS RETURNED AND INSPECTED BY W. FRIEBAUER (DIRECTOR - R&D). IT COULD NOT BE DETERMINED WHICH CUSTOMER THE DEVICE BELONGED TO. REFER TO THE ATTACHED EMAIL "FW ENDSNORZ PHOTOS" FOR THE INSPECTION RESULTS. ROOT CAUSE DESCRIPTION. REFER TO THE ATTACHED EMAIL "FW ENDSNORZ PHOTOS" FOR THE ROOT CAUSE. MANUFACTURER REFERENCE: (B)(4).

Additional Manufacturer Narrative · 0

CORRECTED: G3, H6. MANUFACTURER REFERENCE: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BUTTON FROM AN ENDSNORZ APPLIANCE BROKE OFF. PATIENT HAS A HISTORY OF SLEEP APNEA AND GRINDS TEETH. PATIENT STARTED USING APPLIANCE ON (B)(6) 2023 THRU (B)(6) 2023 CURRENTLY NOT USING A DEVICE AND REPORTS THAT HER SLEEP IS BEING DISTURBED (SNORING). PATIENT WAS USING ULTRASONIC CLEANER WITH REGULAR OSMOSIS WATER TO CLEAN AND MAINTAIN DEVICE. NO OTHER ISSUES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
897131 ENDSNORZ SLEEP APPLIANCE ANTI SNORING NIGHTGAURD LRK PRISMATIK DENTALCRAFT, INC.

Patients

Seq Age Sex Outcome Treatment
1 65 YR Female