FDA Adverse Event Malfunction Summary report: N

FLEXMASTER TAPER 04 STERILE

MDR report key: 19891258 · Received August 2, 2024

Report

Report Number
9611053-2024-00122
Event Type
Malfunction
Date Received
August 2, 2024
Report Date
September 18, 2024
Manufacturer
VDW GMBH
Product Code
EKS
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

AS A RESULT OF THIS MALFUNCTION, THE POTENTIAL FOR SURGICAL INTERVENTION EXISTS TO PRECLUDE PERMANENT DAMAGE TO A BODY STRUCTURE OR PERMANENT IMPAIRMENT OF A BODY FUNCTION AS EVIDENCED BY PREVIOUS REPORTED EVENTS WITH SIMILAR FILES. THIS EVENT, THEREFORE, IS REPORTABLE PER 21CFR PART 803. THE DEVICE IS AVAILABLE FOR EVALUATION, THOUGH HAS NOT BEEN RETURNED AS OF THIS REPORT. EVALUATION RESULTS WILL BE SUBMITTED AS THEY BECOME AVAILABLE.

Additional Manufacturer Narrative · 0

SUMMARY: TWO FLEXMASTER FILES .04 21MM 020 WERE RETURNED IN LOOSE. FIRST ONE IS BROKEN AT THE TIP OF THE ACTIVE PART (FATIGUE), SECOND ONE IS BROKEN IN THE ACTIVE PART (FATIGUE). NO MATERIAL DEFECT WAS FOUND DURING ANALYSIS OF THE RUPTURE PATTERNS. FOR INFORMATION, THIRD FLEXMASTER FILE .04 21MM 020 WHICH BROKE DURING USE WAS NOT RETURNED AND CANNOT BE ANALYZED. NO UNUSED FILE IS AVAILABLE FOR EVALUATION. NOTHING UNUSUAL TO REPORT WAS FOUND DURING DHR REVIEW (BATCH #1780144). ROOT CAUSES ARE NOT IDENTIFIED. WE WILL TRACK THIS KIND OF EVENT AND MONITOR THE TREND.

Description of Event or Problem · 0

IN THIS EVENT IT IS REPORTED THAT A FLEXMASTER TAPER 04 STERILE FILE BROKE DURING USE. THE BROKEN PART COULD NOT BE RETRIEVED AND WAS INCORPORATED INTO THE FILLING. NO INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
912411 FLEXMASTER TAPER 04 STERILE FILE, PULP CANAL, ENDODONTIC EKS VDW GMBH NA

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown