MAUDE Adverse Event Report: DENTSPLY LLC CAVITRON SELECT SPS G124; SCALER, ULTRASONIC

Catalog Number 81324

Device Problem No Flow (2991)

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

Event Type  malfunction  

Event Description

While using a cavitron select sps g124 they allege that no water running and handpiece is hot, no injury resulted.

Manufacturer Narrative

There has been a previous report received where lack of water flow has caused an overheating insert.Since an overheating insert could necessitate medical/surgical intervention to preclude permanent damage to a body structure or permanent impairment of a body function, this malfunction would be likely to cause/contribute to a serious injury should it recur.As such, this event meets the criteria for reportability per 21 cfr 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.

Manufacturer Narrative

Evz potentiometer shorted.Short in the power potentiometer causing the scale power to stay on highest level.Debris buildup in the water filter.Replaced damaged/worn components and recalibrated unit to factory specs.Qa-tl: could not duplicate the complaint of no water and the handpiece getting hot.Check your inserts for any damage or clogging.Make sure only 30k denstply sirona inserts are being used with this unit, any other brand can cause issues.Handpiece 01/2023, hdpc 12/2022.Notes: 04/11/24 repair tech: (b)(4).Evz potentiometer shorted.Short in the power potentiometer causing the scale power to stay on highest level.Debris buildup in the water filter.Replaced damaged/worn components and recalibrated unit to factory specs.Qa-tl: could not duplicate the complaint of no water and the handpiece getting hot.Check your inserts for any damage or clogging.Make sure only 30k denstply sirona inserts are being used with this unit, any other brand can cause issues.Handpiece 01/2023, hdpc 12/2022.Within warranty? no.

• Brand Name: CAVITRON SELECT SPS G124
• Type of Device: SCALER, ULTRASONIC
• Manufacturer (Section D): DENTSPLY LLC; 1301 smile way; york PA 17404
• Manufacturer (Section G): DENTSPLY LLC; 1301 smile way; york PA 17404
• Manufacturer Contact: dan eagar ; 221 w. philadelphia st.; york, PA 17401 ; 7178494593
• MDR Report Key: 18948668
• MDR Text Key: 338228453
• Report Number: 2424472-2024-00022
• Device Sequence Number: 1
• Product Code: ELC
• UDI-Device Identifier: D00381614241
• UDI-Public: D00381614241
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K970123
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Health Professional
• Reporter Occupation: Dentist
• Type of Report: Initial,Followup
• Report Date: 04/15/2024

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: 81324
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 03/20/2024
• Initial Date FDA Received: 03/21/2024
• Supplement Dates Manufacturer Received: 03/20/2024
• Supplement Dates FDA Received: 04/15/2024
• Was Device Evaluated by Manufacturer?: No
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1