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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DENTSPLY LLC CAVITRON SELECT SPS ULTRASONIC SCALER; SCALER, ULTRASONIC

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DENTSPLY LLC CAVITRON SELECT SPS ULTRASONIC SCALER; SCALER, ULTRASONIC Back to Search Results
Model Number G124
Device Problem Overheating of Device (1437)
Patient Problems No Consequences Or Impact To Patient (2199); No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Manufacturer Narrative
While no serious injury resulted in this event, 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.
 
Event Description
While using a g124 scaler, the tips are getting hot; no injury resulted.
 
Manufacturer Narrative
Debris buildup in the water filter.Found restricted water flow when hp cable is held a certain position.Damaged handpiece cable.
 
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Brand Name
CAVITRON SELECT SPS ULTRASONIC SCALER
Type of Device
SCALER, ULTRASONIC
Manufacturer (Section D)
DENTSPLY LLC
1301 smile way
york, pa
MDR Report Key10431893
MDR Text Key204407997
Report Number2424472-2020-00052
Device Sequence Number1
Product Code ELC
Combination Product (y/n)N
PMA/PMN Number
K970123
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional
Type of Report Initial,Followup
Report Date 02/15/2021
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 NumberG124
Device Catalogue Number81324
Was Device Available for Evaluation? Yes
Initial Date Manufacturer Received 07/22/2020
Initial Date FDA Received08/20/2020
Supplement Dates Manufacturer Received02/15/2021
Supplement Dates FDA Received02/15/2021
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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