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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MAILLEFER INSTRUMENTS HOLDING SARL K-FILE M-ACCESS 21MM 010; FILE, PULP CANAL, ENDODONTIC

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MAILLEFER INSTRUMENTS HOLDING SARL K-FILE M-ACCESS 21MM 010; FILE, PULP CANAL, ENDODONTIC Back to Search Results
Catalog Number A12MA02101012
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code Device Embedded In Tissue or Plaque (3165)
Date of Event 12/04/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
We received the following information regarding this complaint 1.The product has not been retained.2.The patient currently has no discomfort reactions.3.No further treatment has been given at the moment.This is a follow up report for this additional information.Investigation; summary: involved product that broke during use was not returned and cannot be analyzed.Moreover, no unused file is available for evaluation.The provided batch #1639343 turns out to have no corresponding with the catalog number involved in this complaint.Right batch number is unknown, dhr cannot be reviewed.Root causes are not identified.We will track this kind of event and monitor the trend.Potential root causes may be incorrect technique (hand used file - technique no more verifiable to date), overuse (number of uses not communicated), excessive wear, patient condition and behavior during treatment or material issue (no analysis of the broken fragments possible).In addition, there are further circumstances on the conditions in dentistry (used disinfectants, training/knowledge status), or any other environmental conditions, which are unknown to us and may also have an impact on the reported failure mode.
 
Additional Manufacturer Narrative
As a result of this malfunction, the potential for surgical intervention exists to preclude permanent damage to a body structure or permanent impairment of a body function as evidenced by previous reported events with similar files.This event, therefore, is reportable per 21cfr part 803.The device was not returned for evaluation.However, the lot number was provided and retained-product testing and/or dhr review are planned.The results will be submitted as they become available.
 
Event or Problem Description
In this event it is reported that a k-file m-access 21mm 010 file broke during use.The broken part could not be retrieved and was incorporated into the fill.The patient will be observed.Further information requested.
 
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Brand Name
K-FILE M-ACCESS 21MM 010
Common Device Name
FILE, PULP CANAL, ENDODONTIC
Manufacturer (Section D)
MAILLEFER INSTRUMENTS HOLDING SARL
ch. du verger 3
ballaigues vaud CH-13 38
SZ  CH-1338
Manufacturer (Section G)
MAILLEFER INSTRUMENTS HOLDING SARL
ch. du verger 3
ballaigues vaud CH-13 38
SZ   CH-1338
Manufacturer Contact
dan eagar
221 west philadelphia st.
york, PA 17401
7178457511
MDR Report Key23818687
Report Number8031010-2025-00227
Device Sequence Number18665099
Product Code EKS
UDI-Device IdentifierJ003A12MA021010121
UDI-PublicJ003A12MA021010121
Combination Product (Y/N)N
Initial Reporter CountryCH
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Dentist
Type of Report Initial,Followup
Report Date (Section B) 12/22/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Catalogue NumberA12MA02101012
Device Lot Number1639343
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Distributor Facility Aware Date12/06/2025
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 12/06/2025
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date12/16/2025
Supplement Report FDA Received Date12/22/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Usage of Device A
Patient Sequence Number1
Patient SexUnknown
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