FDA Adverse Event Malfunction Summary report: N

PROPOST

MDR report key: 6215788 · Received December 30, 2016

Report

Report Number
2320721-2016-00073
Event Type
Malfunction
Date Received
December 30, 2016
Date of Event
November 29, 2016
Report Date
March 24, 2017
Manufacturer
DENTSPLY TULSA DENTAL SPECIALTIES
Product Code
ELR
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
DENTIST

Narratives

Additional Manufacturer Narrative · 1

MULTIPLE UNSUCCESSFUL ATTEMPTS WERE MADE TO OBTAIN THE DEVICE FOR EVALUATION. THE LOT NUMBER REPORTED WAS FOUND TO BE INVALID. THEREFORE, RETAINED-PRODUCT TESTING AND/OR DHR REVIEW IS NOT POSSIBLE.

Additional Manufacturer Narrative · 1

THERE HAS BEEN A PREVIOUS REPORT RECEIVED WHERE THIS MALFUNCTION RESULTED IN A SERIOUS INJURY. THEREFORE, IT MUST BE PRESUMED THAT RECURRENCE OF THIS MALFUNCTION COULD POSSIBLY CAUSE OR CONTRIBUTE TO A SERIOUS INJURY OR REQUIRE MEDICAL OR SURGICAL INTERVENTION TO PRECLUDE SUCH. AS SUCH, THIS EVENT 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.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PROPOST POST BROKE DURING PLACEMENT. THE POST WAS RETRIEVED AND THE DENTIST WAS ABLE TO SEAT ANOTHER POST AND COMPLETE THE RESTORATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
866163 PROPOST POST, ROOT CANAL ELR DENTSPLY TULSA DENTAL SPECIALTIES NA 44012116

Patients

Seq Age Sex Outcome Treatment
1