Brand Name | START-X TIP |
Type of Device | SCALER, ULTRASONIC |
Manufacturer (Section D) |
DENTSPLY MAILLEFER |
chemin du verger 3 |
ballaigues, 1338 |
SZ 1338 |
|
Manufacturer (Section G) |
DENTSPLY MAILLEFER |
chemin du verger 3 |
|
ballaigues, 1338 |
SZ
1338
|
|
Manufacturer Contact |
karl
nittinger
|
221 w. philadelphia st. |
suite 60w |
york, PA 17401
|
7178494424
|
|
MDR Report Key | 11073341 |
MDR Text Key | 226853173 |
Report Number | 8031010-2020-00266 |
Device Sequence Number | 1 |
Product Code |
ELC
|
Combination Product (y/n) | N |
Reporter Country Code | PL |
PMA/PMN Number | NA |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
foreign |
Reporter Occupation |
Non-Healthcare Professional
|
Type of Report
| Initial |
Report Date |
12/24/2020 |
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 Catalogue Number | A066100000300 |
Was Device Available for Evaluation? |
No
|
Initial Date Manufacturer Received |
11/24/2020
|
Initial Date FDA Received | 12/24/2020 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |
|
|