MAUDE Adverse Event Report: SIRONA DENTAL SYSTEMS GMBH MIDWEST STYLUS ATC; HANDPIECE, AIR-POWERED, DENTAL

Catalog Number 884310

Device Problem Overheating of Device (1437)

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

Event Type  malfunction  

Manufacturer Narrative

1 of 1 device was returned for evaluation.Evaluation of 1 device found excessive wear due to a lack of proper maintenance.The device did not heat up during evaluation.The device was repaired and returned to the customer.

Event Description

This report summarizes 1 malfunction event where a midwest stylus atc handpiece overheated.No injury resulted in this event.

Manufacturer Narrative

The information in field d3 was inadvertently missed during the initial submission.This submission is to correct the report to include this additional information.

• Brand Name: MIDWEST STYLUS ATC
• Type of Device: HANDPIECE, AIR-POWERED, DENTAL
• Manufacturer (Section D): SIRONA DENTAL SYSTEMS GMBH; fabrikstrasse 31; bensheim, hessen D-646 25; GM D-64625
• MDR Report Key: 11758353
• MDR Text Key: 251733222
• Report Number: 9614977-2021-00004
• Device Sequence Number: 1
• Product Code: EFB
• Combination Product (y/n): N
• PMA/PMN Number: K003518
• Number of Events Reported: 1
• Summary Report (Y/N): Y
• Report Source: Manufacturer
• Type of Report: Initial,Followup
• Report Date: 06/09/2021

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 04/30/2021
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: No
• Device Operator: No Information
• Device Catalogue Number: 884310
• Device Lot Number: 4247
• Patient Sequence Number: 1