| Brand Name | HENRY SCHEIN |
| Common Device Name | CURING LIGHT |
| Manufacturer (Section D) |
| MONITEX INDUSTRIAL CO. LTD. |
| 5f, 70, sec. 1, guangfu road., |
| sanchong dist.,, new taipei 241 |
| TW 241 |
|
| MDR Report Key | 24097131 |
| Report Number | 3007007357-2026-00001 |
| Device Sequence Number | 21431736 |
| Product Code |
EBZ
|
| UDI-Device Identifier | 00304040186008 |
| UDI-Public | (01)00304040186008 |
| Combination Product (Y/N) | N |
| Initial Reporter State | TX |
| Initial Reporter Country | US |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Importer
|
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
01/16/2026 |
| Report Date (Section F) |
01/16/2026 |
| 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? |
No
|
| Operator of Device |
Health Professional
|
| Device Model Number | MAXIMA ADVANCED 3000 LED |
| Device Catalogue Number | 570-3853 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Date Returned to Manufacturer | 01/19/2026 |
| Was the Report Sent to FDA? |
Yes
|
| Distributor Facility Aware Date | 12/18/2025 |
| Device Age | 9 MO |
| Event Location |
Outpatient Treatment Facility
|
| Date Report to Manufacturer | 01/16/2026 |
| Initial Date Received by Manufacturer | Not provided |
| Initial Report FDA Received Date | 01/16/2026 |
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Other;
|
| Patient Age | 43 YR |
| Patient Sex | Female |
| Date Report Sent to FDA | 01/16/2026 |
|
|