FDA Adverse Event
Malfunction
Summary report: N
PROPEX
MDR report key: 2132402
·
Received June 13, 2011
Report
- Report Number
- 8031010-2011-00085
- Event Type
- Malfunction
- Date Received
- June 13, 2011
- Report Date
- May 25, 2011
- Manufacturer
- DENTSPLY MAILLEFER
- Product Code
- LQY
- PMA / PMN Number
- K992233
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IT
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
WHILE NO SERIOUS INJURY RESULTED IN THIS EVENT, THERE HAS BEEN A PREVIOUS REPORT REC'D WITHIN THE PAST TWO YRS INVOLVING THIS MALFUNCTION THAT RESULTED IN A SERIOUS INJURY. THEREFORE, THIS EVENT MEETS THE CRITERIA FOR REPORTABILITY PER 21 CFR PART 803. THE DEVICE IS AVAILABLE FOR EVAL, THOUGH HAS NOT BEEN RETURNED AS OF THIS REPORT.
Description of Event or Problem · 1
IN THIS EVENT, IT WAS REPORTED THAT A PROPEX II APEX LOCATOR PROVIDED INCORRECT MEASUREMENTS; NO INJURY RESULTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PROPEX | LQY | DENTSPLY MAILLEFER | 1042401 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |