MAUDE Adverse Event Report: LARES RESEARCH LARES RESEARCH; HIGH-SPEED DENTAL HANDPIECE

Model Number 557 PROSTYLE SF

Device Problem Mechanical Problem (1384)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Date 09/07/2023

Event Type  malfunction  

Manufacturer Narrative

The device was tested and did not meet the requirements for holding a bur.There was significant debris and corrosion in the spindle which was a result of not cleaning and lubricating the chucking mechanism.

Event Description

Dr.Sent device in for repair with a note indicating the bur does not stay in the head during procedures.There was no incident of a patient swallowing a bur.

• Brand Name: LARES RESEARCH
• Type of Device: HIGH-SPEED DENTAL HANDPIECE
• Manufacturer (Section D): LARES RESEARCH; 295 lockheed avenue; chico 95973
• Manufacturer (Section G): LARES RESEARCH; 295 lockheed avenue; chico 95973
• Manufacturer Contact: bruce holderbein ; 295 lockheed avenue; chico 95973 ; 5303451767
• MDR Report Key: 17722188
• MDR Text Key: 323105809
• Report Number: 2916440-2023-00015
• Device Sequence Number: 1
• Product Code: EFB
• UDI-Device Identifier: D950131252220
• UDI-Public: D950131252220
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K141221
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Health Professional
• Reporter Occupation: Dentist
• Remedial Action: Repair
• Type of Report: Initial
• Report Date: 09/11/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Model Number: 557 PROSTYLE SF
• Device Catalogue Number: 13125-222
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 09/07/2023
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 09/07/2023
• Initial Date FDA Received: 09/11/2023
• Was Device Evaluated by Manufacturer?: Yes
• Date Device Manufactured: 09/30/2022
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Reuse
• Patient Sequence Number: 1