FDA Adverse Event
Malfunction
Summary report: N
30K FSI-SLI-FG-10S INS,PKD
MDR report key: 25198808
·
Received May 18, 2026
Report
- Report Number
- 2424472-2026-00736
- Event Type
- Malfunction
- Date Received
- May 18, 2026
- Report Date
- May 18, 2026
- Manufacturer
- DENTSPLY LLC
- Product Code
- ELC
- UDI-DI
- D003820051
- PMA / PMN Number
- K052334/K970
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA
- Reporter Occupation
- DENTIST
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
SINCE AN OVERHEATING INSERT COULD NECESSITATE MEDICAL/SURGICAL INTERVENTION TO PRECLUDE PERMANENT DAMAGE TO A BODY STRUCTURE OR PERMANENT IMPAIRMENT OF A BODY FUNCTION, THIS MALFUNCTION WOULD BE LIKELY TO CAUSE/CONTRIBUTE TO A SERIOUS INJURY SHOULD IT RECUR. AS SUCH, THIS EVENT MEETS THE CRITERIA FOR REPORTABILITY PER 21 CFR 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.
Description of Event or Problem · 0
IN THIS EVENT IT IS REPORTED THAT A 30K FSI-SLI-FG-10S INS,PKD IS ALLEGED THE TIP IS HEATING UP AND NOT SPRAYING WATER. NO INJURY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 542104 | 30K FSI-SLI-FG-10S INS,PKD | SCALER, ULTRASONIC | ELC | DENTSPLY LLC | 24094 | D003820051 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |