FDA Adverse Event Injury Summary report: N

AH PLUS BIOCERAMIC SEALER REFILL SYRINGE

MDR report key: 22769612 · Received August 11, 2025

Report

Report Number
2320721-2025-00085
Event Type
Injury
Date Received
August 11, 2025
Date of Event
August 6, 2025
Report Date
August 11, 2025
Manufacturer
TULSA DENTAL PRODUCTS LLC
Product Code
KIF
UDI-DI
D716AHPBIOREFILL1
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
DENTIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

WHILE NO SERIOUS INJURY RESULTED IN THIS EVENT, IF THIS MALFUNCTION RECURRED, IT COULD CAUSE OR CONTRIBUTE TO A SERIOUS INJURY OR REQUIRE MEDICAL OR SURGICAL INTERVENTION TO PRECLUDE SUCH. THIS EVENT, THEREFORE, IS REPORTABLE PER 21CFR PART 803. CUSTOMER NOT RETURNING AND NO LOT NUMBER PROVIDED. PRODUCT NOT RECEIVED AT INVESTIGATION SITE.

Description of Event or Problem · 0

IN THIS EVENT IT WAS REPORTED THAT THE AHPBIOSEAL SHOWED RESORPTION REQUIRING RETREATMENT. NO PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2160736 AH PLUS BIOCERAMIC SEALER REFILL SYRINGE RESIN, ROOT CANAL FILLING KIF TULSA DENTAL PRODUCTS LLC UNK D716AHPBIOREFILL1

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention