| Brand Name | MGUIDE MOTOR INSERTION TOOL, CONI. CON., SP |
| Common Device Name | ACCESSORIES, IMPLANT, DENTAL, ENDOSSEOUS |
| Manufacturer (Section D) |
| MIS IMPLANTS TECHNOLOGIES LTD. |
| p.o. box 7 |
| bar lev industrial park 20156 00 |
| IS 2015600 |
|
| Manufacturer (Section G) |
| MIS IMPLANTS TECHNOLOGIES LTD. |
| p.o. box 7 |
|
| bar lev industrial park 20156 00 |
|
IS
2015600
|
|
| Manufacturer Contact |
|
dan
eagar
|
| 221 west philadelphia st. |
| york, PA 17401
|
|
7178457511
|
|
| MDR Report Key | 25618936 |
| Report Number | 3004203816-2026-15772 |
| Device Sequence Number | 10195129 |
| Product Code |
NDP
|
| UDI-Device Identifier | 07290109011790 |
| UDI-Public | 07290109011790 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | RS |
| PMA/510(K) Number | EXEMPT |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Other,Foreign |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
06/25/2026 |
| 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
|
| Operator of Device |
Health Professional
|
| Device Catalogue Number | CG-GMS10 |
| Distributor Facility Aware Date | 06/01/2026 |
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 06/01/2026 |
| Initial Report FDA Received Date | 06/25/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|