FDA Adverse Event Malfunction Summary report: N

SONENDO OMNICLEAN (GENTLEWAVE) ENDOTHERAPYSYSTEM

MDR report key: 4600527 · Received March 10, 2015

Report

Report Number
3010817521-2015-00004
Event Type
Malfunction
Date Received
March 10, 2015
Date of Event
February 11, 2015
Report Date
March 9, 2015
Manufacturer
SONENDO INC.
Product Code
ELC
PMA / PMN Number
K133752
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

A FIELD SERVICE ENGINEER SERVICE THE DEVICE IN QUESTION AT THE ENDODONTIST'S OFFICE. THE ENGINEER DISCOVERED THAT A COMPONENT OF THE FLUID BOTTLE (FEMALE) CONNECTOR WAS BROKEN WHICH INTERRUPTED FLUID DELIVERY INTO THE SYSTEM. THE ENGINEER SIMULATED THE FAILURE BY RUNNING THREE TREATMENT CYCLES OF THE SYSTEM TO COMPLETION. THE CYCLERS VERIFIED THE USER'S DESCRIPTION OF THE EVENT. THE ENGINEER REPLACED THE BOTTLE CAP, WHICH INCLUDES THE FEMALE CONNECTOR WITH "NEW FROM STOCK" PARTS AND SUBSEQUENTLY RAN MULTIPLE CYCLES TO ENSURE THE APPROPRIATE VOLUME OF FLUID WAS BEING DELIVERED TO THE SYSTEM. AFTER THE COMPONENTS WERE REPLACED, A SYSTEM TEST WAS CONDUCTED AND RESULTED IN THE SYSTEM PERFORMING WITHIN SPECIFICATION. THIS SERVICE ACTIVITY IS CONSISTENT WITH SONDENDO'S PREVENTIVE MAINTENANCE PLAN FOR THE SYSTEM FLUID BOTTLES.

Description of Event or Problem · 1

AFTER COMPLETION OF ROOT CANAL THERAPY WITH THE SENENDO OMNICLEAN GENTLEWAVE SYSTEM, IT WAS OBSERVED BY THE ENDODONTIST THAT THE EXPECTED VOLUME OF TREATMENT FLUID WAS NOT CONSUMED. NO PATIENT INJURY WAS REPORTED IN THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
166050 SONENDO OMNICLEAN (GENTLEWAVE) ENDOTHERAPYSYSTEM ULTRASONIC SCALER ELC SONENDO INC. FG-006-00001 W2014111303

Patients

Seq Age Sex Outcome Treatment
1 74 YR