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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: X-SMART ENDO MOTOR WITH CONTRA ANGLE HANDPIECE; HANDPIECE, DIRECT DRIVE, AC-POWERED

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X-SMART ENDO MOTOR WITH CONTRA ANGLE HANDPIECE; HANDPIECE, DIRECT DRIVE, AC-POWERED Back to Search Results
Catalog Number A100400000000
Device Problems Defective Device (2588); Detachment of Device or Device Component (2907)
Patient Problems No Consequences Or Impact To Patient (2199); No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Manufacturer Narrative
There has been a previous report received with a similar device 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
In this event it was reported that a x-smart contra angle won't hold files; no injury resulted.
 
Manufacturer Narrative
X-smart head cap.Bad maintenance (user).The file is hard to remove, this failure is probably caused by rust or other foreign matter in the head cap.X-smart cartridge.Various mechanical problem.I note that the cartridge is blocked.X-smart neck.Various mechanical problem.Ball bearing of the neck is defective.It is not possible to be determined the root cause with certainty.The root cause is either a mechanical problem or a bad maintenance of user.Replaced 1 x x cartridge h1004c5210150, 1 x x neck h1004c5470220 and 1 x x head cap h1004c5210500.
 
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Brand Name
X-SMART ENDO MOTOR WITH CONTRA ANGLE HANDPIECE
Type of Device
HANDPIECE, DIRECT DRIVE, AC-POWERED
MDR Report Key10431897
MDR Text Key204402206
Report Number8031010-2020-00155
Device Sequence Number1
Product Code EKX
Combination Product (y/n)N
PMA/PMN Number
K990682
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type foreign,health professional
Type of Report Initial,Followup
Report Date 10/05/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/20/2020
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberA100400000000
Was Device Available for Evaluation? Yes
Date Manufacturer Received07/22/2020
Was Device Evaluated by Manufacturer? No
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
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