| Brand Name | T3 MINI MIDWEST |
| Common Device Name | HANDPIECE, AIR-POWERED, DENTAL |
| Manufacturer (Section D) |
| SIRONA DENTAL SYSTEMS GMBH |
| fabrikstrasse 31 |
| bensheim, hessen D-646 25 |
| GM D-64625 |
|
| Manufacturer (Section G) |
| SIRONA DENTAL SYSTEMS GMBH |
| fabrikstrasse 31 |
|
| bensheim, hessen D-646 25 |
|
GM
D-64625
|
|
| Manufacturer Contact |
|
dan
eagar
|
| 221 w. philadelphia st. |
| york, PA 17401
|
|
7178494593
|
|
| MDR Report Key | 21880829 |
| Report Number | 9614977-2025-00011 |
| Device Sequence Number | 15613616 |
| Product Code |
EFB
|
| UDI-Device Identifier | E27663879840 |
| UDI-Public | E27663879840 |
| Combination Product (Y/N) | N |
| PMA/510(K) Number | K972436 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | Y |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial |
| Report Date (Section B) |
04/15/2025 |
| 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 Catalogue Number | 6689926 |
| Type of Report(Section G) | Initial |
| Initial Date Received by Manufacturer | Not provided |
| Initial Report FDA Received Date | 04/22/2025 |
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|