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U.S. Department of Health and Human Services

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

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LARES RESEARCH LARES RESEARCH; HIGH-SPEED DENTAL HANDPIECE Back to Search Results
Model Number PROSTYLE SF 557
Device Problem Mechanical Problem (1384)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 07/10/2023
Event Type  malfunction  
Manufacturer Narrative
Device was inspected and the spindle was cracked.No cause for the crack was determined.
 
Event Description
Dr indicated burs keep coming out of high-speed handpiece during dental procedures.
 
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Brand Name
LARES RESEARCH
Type of Device
HIGH-SPEED DENTAL HANDPIECE
Manufacturer (Section D)
LARES RESEARCH
295 lockheed avenue
chico CA 95973
Manufacturer (Section G)
LARES RESEARCH
295 lockheed avenue
chico CA 95973
Manufacturer Contact
bruce holderbein
295 lockheed avenue
chico, CA 95973
5303451767
MDR Report Key17303070
MDR Text Key319477247
Report Number2916440-2023-00011
Device Sequence Number1
Product Code EFB
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K141221
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional
Reporter Occupation Dentist
Remedial Action Replace
Type of Report Initial
Report Date 07/11/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received07/11/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberPROSTYLE SF 557
Device Catalogue Number13124-222
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer07/10/2023
Is the Reporter a Health Professional? Yes
Date Manufacturer Received07/10/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/26/2018
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
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